Healthcare Provider Details

I. General information

NPI: 1720549736
Provider Name (Legal Business Name): FELICIA HAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2019
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 FLORIDA AVE
MODESTO CA
95350-4405
US

IV. Provider business mailing address

PO BOX 19406
BELFAST ME
04915-4089
US

V. Phone/Fax

Practice location:
  • Phone: 209-578-1211
  • Fax: 209-576-3888
Mailing address:
  • Phone: 760-323-6511
  • Fax: 760-416-4825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number20A22892
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: