Healthcare Provider Details

I. General information

NPI: 1912276965
Provider Name (Legal Business Name): ROBIN DAO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2011
Last Update Date: 12/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12275 PERRIS BLVD
MORENO VALLEY CA
92557-7432
US

IV. Provider business mailing address

PO BOX 9222
MORENO VALLEY CA
92552-9222
US

V. Phone/Fax

Practice location:
  • Phone: 951-242-8717
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number60839
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: