Provider Demographics
NPI:1932721255
Name:DINH, BICHVAN THUY
Entity type:Individual
Prefix:
First Name:BICHVAN
Middle Name:THUY
Last Name:DINH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9049 LEMONGRASS CT
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-5604
Mailing Address - Country:US
Mailing Address - Phone:714-602-1515
Mailing Address - Fax:714-242-1599
Practice Address - Street 1:139 S LINCOLN ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-2235
Practice Address - Country:US
Practice Address - Phone:714-602-1515
Practice Address - Fax:714-242-1599
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-08
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA306005721310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility