Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 20A6290 | CA |
NPI | 1730156027 |
---|---|
Provider Name | Mr. Ngon Hoang Dinh |
First Address | San Jose, CA 95112-1919 |
Second Address | San Jose, CA 95116-1587 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2006 |
Last Update Date | 04/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00AX62900 | (05) | CA |
F66059 | (02) | CA |