Healthcare Provider Details

I. General information

NPI: 1982917894
Provider Name (Legal Business Name): DANIEL KAO M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2010
Last Update Date: 02/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3020 CHILDRENS WAY # MC5075
SAN DIEGO CA
92123-4223
US

IV. Provider business mailing address

2445 RIDGEGATE ROW
LA JOLLA CA
92037
US

V. Phone/Fax

Practice location:
  • Phone: 310-617-4227
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101244152
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA90174
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: