Healthcare Provider Details

I. General information

NPI: 1033182951
Provider Name (Legal Business Name): MICHAEL JASON DAO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 12/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14362 BROOKHURST ST
GARDEN GROVE CA
92843-4608
US

IV. Provider business mailing address

14362 BROOKHURST ST
GARDEN GROVE CA
92843-4608
US

V. Phone/Fax

Practice location:
  • Phone: 714-531-7830
  • Fax: 714-531-3763
Mailing address:
  • Phone: 714-531-7830
  • Fax: 714-531-3763

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA87942
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: