Healthcare Provider Details

I. General information

NPI: 1063700664
Provider Name (Legal Business Name): QUYNH DAO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: QUYNH VAN DAO NP

II. Dates (important events)

Enumeration Date: 07/16/2011
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2080 CENTURY PARK E STE 1807
LOS ANGELES CA
90067-2021
US

IV. Provider business mailing address

2080 CENTURY PARK E STE 1807
LOS ANGELES CA
90067-2021
US

V. Phone/Fax

Practice location:
  • Phone: 310-504-1231
  • Fax: 323-486-9898
Mailing address:
  • Phone: 310-504-1231
  • Fax: 323-486-9898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number20686
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: