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Organization

LYNN DIMINO MD INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LYNN DIMINO MD (PHYSICIAN)
(949) 721-8300
Entity
Organization

Contact information

Practice address
360 SAN MIGUEL DR, SUITE 603, NEWPORT BEACH, CA 92660-7853
(949) 721-8300
(949) 721-8833
Mailing address
360 SAN MIGUEL DR, SUITE 603, NEWPORT BEACH, CA 92660-7853
(949) 721-8300
(949) 721-8833

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G71777
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1609072446
MEDICARE, BLUE SHIELD
CA
01
1699724542
ALL OTHER INSURANCES
CA
Enumeration date
06/26/2007
Last updated
12/28/2007
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