1558540849 NPI number — LINH C. HUYNH

Table of content: (NPI 1558540849)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558540849 NPI number — LINH C. HUYNH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LINH C. HUYNH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FOOT & ANKLE CARE CLINIC
Provider Other Organization Name Type Code:
3
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:
1558540849
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/02/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
875 E CANAL DR STE 10
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TURLOCK
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95380-4542
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
209-667-5255
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
875 E CANAL DR STE 10
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TURLOCK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95380-4542
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-667-5255
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/02/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HUYNH
Authorized Official First Name:
LINH
Authorized Official Middle Name:
C
Authorized Official Title or Position:
PODIATRIST
Authorized Official Telephone Number:
209-667-5255

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  E4305 , 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: 000E43051 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000E43052 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000E43050 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".