Healthcare Provider Details

I. General information

NPI: 1548757271
Provider Name (Legal Business Name): NANCY DAO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2018
Last Update Date: 12/19/2019
Certification Date: 12/19/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 SUPERIOR AVE
COSTA MESA CA
92627-3653
US

IV. Provider business mailing address

1550 SUPERIOR AVE
COSTA MESA CA
92627-3653
US

V. Phone/Fax

Practice location:
  • Phone: 949-270-2100
  • Fax: 949-650-4458
Mailing address:
  • Phone: 949-270-2100
  • Fax: 949-650-4458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number77399
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: