Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | NP95012289 | CA |
N | 363LP2300X | Nurse Practitioner - Primary Care | NP95012289 | CA |
NPI | 1083255871 |
---|---|
Provider Name | Lina Huynh |
First Address | Westminster, CA 92683-7514 |
Second Address | Westminster, CA 92683-1307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2019 |
Last Update Date | 02/10/2019 |