Healthcare Provider Details

I. General information

NPI: 1689797920
Provider Name (Legal Business Name): MICHAEL M DAO MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 04/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9191 WESTMINSTER AVE
GARDEN GROVE CA
92844-2751
US

IV. Provider business mailing address

9191 WESTMINSTER AVE
GARDEN GROVE CA
92844
US

V. Phone/Fax

Practice location:
  • Phone: 714-899-2000
  • Fax: 714-899-0051
Mailing address:
  • Phone: 714-899-2000
  • Fax: 714-899-0051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC43051
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA51334
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA83099
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA68450
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A7978
License Number StateCA

VIII. Authorized Official

Name: TOM NGUYEN
Title or Position: MANAGER
Credential: MD
Phone: 714-583-6279