1114251956 NPI number — DR. MY-LINH HOANG TRINH MD

Table of content: DR. MY-LINH HOANG TRINH MD (NPI 1114251956)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114251956 NPI number — DR. MY-LINH HOANG TRINH MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TRINH
Provider First Name:
MY-LINH
Provider Middle Name:
HOANG
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114251956
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/01/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9143 VALLEY BLVD
Provider Second Line Business Mailing Address:
SUITE 201A
Provider Business Mailing Address City Name:
ROSEMEAD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91770-1991
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9143 VALLEY BLVD
Provider Second Line Business Practice Location Address:
SUITE 201A
Provider Business Practice Location Address City Name:
ROSEMEAD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91770-1991
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-872-0657
Provider Business Practice Location Address Fax Number:
626-470-9736
Provider Enumeration Date:
09/27/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  A127452 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: A127452 . This is a "CALIFORNIA MEDICAL LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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