Provider Demographics
NPI:1881357333
Name:DINH, KEVIN HOANG (PHARMD)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:HOANG
Last Name:DINH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1922 LEXINGTON DR
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3537
Mailing Address - Country:US
Mailing Address - Phone:714-515-2361
Mailing Address - Fax:
Practice Address - Street 1:14571 MAGNOLIA ST STE 104
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5575
Practice Address - Country:US
Practice Address - Phone:714-893-2697
Practice Address - Fax:714-893-3897
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA849613336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy