MEDICARE: LA K DINH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	NP95013547	CA

General Provider Information

NPI Number	:	1932734365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LA K DINH

Provider Business Mailing Address
First Line	:	28251 CAPITOLA ST
Second Line	:
City	:	HAYWARD
State	:	CA
Zip	:	94545-4871
Country	:	US
Telephone Number	:	510-329-4097
Fax Number	:

Provider Business Practice Location Address
First Line	:	749 STORY RD STE 20
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95122-2600
Country	:	US
Telephone Number	:	408-794-2088
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2020
Last Update Date	:	03/05/2020

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Directions to “ LA K DINH ” Practice Location

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