Healthcare Provider Details

I. General information

NPI: 1427007202
Provider Name (Legal Business Name): JUNG T DAO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 05/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3815 E BELL RD SUITE 2500
PHOENIX AZ
85032-2122
US

IV. Provider business mailing address

3815 E BELL RD SUITE 2500
PHOENIX AZ
85032-2122
US

V. Phone/Fax

Practice location:
  • Phone: 602-258-4321
  • Fax: 602-253-5917
Mailing address:
  • Phone: 602-258-4321
  • Fax: 602-253-5917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number29246
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: