MEDICARE: DR. SOPHIE K DAO O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	8213T	CA
2	152WC0802X	Corneal and Contact Management Optometrist	8213T	CA
3	152WP0200X	Pediatric Optometrist	8213T	CA
4	152WS0006X	Sports Vision Optometrist	8213T	CA
5	152WX0102X	Occupational Vision Optometrist	8213T	CA
6	156FC0800X	Contact Lens Technician/Technologist	8213T	CA
7	156FC0801X	Contact Lens Fitter	8213T	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12671	OTHER		MEDICAL EYE SERVICES
2	SD0082130	OTHER	CA	MEDICAL PROVIDER ID
3	51733	OTHER		DAVIS VISION
4	CA8213	OTHER	CA	EYEMED PROVIDER ID
5	SD09818	OTHER	CA	SPECTERA PROVIDER ID
6	770485005	OTHER		NATIONAL VISION ADMINISTRATORS NETWORK

General Provider Information

NPI Number	:	1104896513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SOPHIE K DAO O.D.

Provider Business Mailing Address
First Line	:	991 MONTAGUE EXPY STE 111
Second Line	:
City	:	MILPITAS
State	:	CA
Zip	:	95035-6809
Country	:	US
Telephone Number	:	408-262-1221
Fax Number	:	408-262-0789

Provider Business Practice Location Address
First Line	:	991 MONTAGUE EXPY STE 111
Second Line	:
City	:	MILPITAS
State	:	CA
Zip	:	95035-6818
Country	:	US
Telephone Number	:	408-262-1221
Fax Number	:	408-262-0789

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	11/29/2010

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