Individual provider Active NPI

Marykim Dinh

  • Nutritionist
  • Garden Grove, CA
National Provider Identifier
1255094975
Registry record updated Oct 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
Practice address
6962 Brightwood LN
Garden Grove, CA 92845-2961
Phone
(714) 204-9633
NPI assigned
Oct 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X Primary

Addresses

Primary practice location

6962 Brightwood LN
Garden Grove, CA 92845-2961

Mailing address

6962 Brightwood LN Apt 32
Garden Grove, CA 92845-2961

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1255094975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6962 BRIGHTWOOD LN APT 32",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928452961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6962 BRIGHTWOOD LN",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928452961",
            "telephone_number": "714-204-9633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINH",
        "first_name": "MARYKIM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-19",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.