Healthcare Provider Details

I. General information

NPI: 1528196557
Provider Name (Legal Business Name): HUNG DUY DAO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 N WINCHESTER BLVD SUITE 2G
SAN JOSE CA
95128-1313
US

IV. Provider business mailing address

826 N WINCHESTER BLVD SUITE 2G
SAN JOSE CA
95128-1313
US

V. Phone/Fax

Practice location:
  • Phone: 408-261-3646
  • Fax: 408-385-1853
Mailing address:
  • Phone: 408-261-3646
  • Fax: 408-385-1853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-30446
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: