Healthcare Provider Details

I. General information

NPI: 1215942818
Provider Name (Legal Business Name): DANTHUY NGOC DAO D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 05/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 W THOMAS RD
PHOENIX AZ
85013-4409
US

IV. Provider business mailing address

PO BOX 27340
PHOENIX AZ
85061-7340
US

V. Phone/Fax

Practice location:
  • Phone: 602-406-3000
  • Fax: 602-235-9159
Mailing address:
  • Phone: 602-943-9200
  • Fax: 602-235-9159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4461
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number4461
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: