Provider Demographics
NPI:1316238785
Name:DINH, LINH VU (OD)
Entity type:Individual
Prefix:DR
First Name:LINH
Middle Name:VU
Last Name:DINH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10161 BOLSA AVE STE 104C
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-6779
Mailing Address - Country:US
Mailing Address - Phone:714-775-0026
Mailing Address - Fax:714-775-0019
Practice Address - Street 1:10161 BOLSA AVENUE, # 104C
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683
Practice Address - Country:US
Practice Address - Phone:714-775-0026
Practice Address - Fax:714-775-0028
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-20
Last Update Date:2014-02-19
Deactivation Date:2011-05-23
Deactivation Code:
Reactivation Date:2013-08-07
Provider Licenses
StateLicense IDTaxonomies
CAOPTOMETRIST152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB207125Medicare PIN