Healthcare Provider Details

I. General information

NPI: 1992784292
Provider Name (Legal Business Name): STEVE DAO OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 11/29/2021
Certification Date: 11/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31401 RANCHO VIEJO RD SUITE 103
SAN JUAN CAPISTRANO CA
92675-1851
US

IV. Provider business mailing address

22 ARRIVO DR
MISSION VIEJO CA
92692-5118
US

V. Phone/Fax

Practice location:
  • Phone: 949-248-2590
  • Fax: 949-443-3828
Mailing address:
  • Phone: 714-349-4168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1181
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number11275
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: