Provider Demographics
NPI:1962590034
Name:DINH, LONG H (OD)
Entity type:Individual
Prefix:DR
First Name:LONG
Middle Name:H
Last Name:DINH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11657 CHERYL RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-6071
Mailing Address - Country:US
Mailing Address - Phone:858-205-5521
Mailing Address - Fax:
Practice Address - Street 1:650 GATEWAY CENTER DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92102-4530
Practice Address - Country:US
Practice Address - Phone:619-262-2494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12799T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist