Organization Active NPI

Chinh T. Dinh, a Professional Medical Corporation

  • Family Medicine Physician
  • Anaheim, CA
National Provider Identifier
1093958464
Registry record updated Apr 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A65428 Issued in CA
Legal business name
CHINH T. DINH, A PROFESSIONAL MEDICAL CORPORATION
Practice address
3414 W Ball Rd Ste F
Anaheim, CA 92804-3726
Phone
(714) 761-9137
NPI assigned
Apr 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Chinh Thien Dinh, MDNPI 1639244049
Title
President
Phone
(714) 761-9137

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X A65428 CA Primary

Addresses

Primary practice location

3414 W Ball Rd Ste F
Anaheim, CA 92804-3726

Mailing address

3414 W Ball Rd Ste F
Anaheim, CA 92804-3726
Phone (714) 761-9137

Other names 1

  • Knott-Ball Anaheim Medical Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091020000509 CA Part B Supplier - Clinic/Group Practice 5092852269 Receives reassigned benefits from 1 practitioner
Practice locations: Anaheim, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0982140Knott-Ball Anaheim Medical Clinic3414 W Ball Rd Ste F, Anaheim, CA 92804Certificate of waiverJan 16, 2027

National Provider Directory

National Provider Directory

Locations

3414 W Ball Rd
Ste F
Anaheim, CA 92804
Phone (714) 761-9137

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1239667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239667200000",
    "number": "1093958464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3414 W BALL RD STE F",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043726",
            "telephone_number": "714-761-9137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3414 W BALL RD STE F",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043726",
            "telephone_number": "714-761-9137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHINH T. DINH, A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-14",
        "last_updated": "2009-04-14",
        "status": "A",
        "authorized_official_last_name": "DINH",
        "authorized_official_first_name": "CHINH",
        "authorized_official_middle_name": "THIEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-761-9137",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A65428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Knott-Ball Anaheim Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.