Healthcare Provider Details

I. General information

NPI: 1679197578
Provider Name (Legal Business Name): EUGENE HAN DAO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2020
Last Update Date: 05/04/2025
Certification Date: 05/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE FL 3
SAN FRANCISCO CA
94143-2204
US

IV. Provider business mailing address

1200 S CEDAR CREST BLVD
ALLENTOWN PA
18103-6202
US

V. Phone/Fax

Practice location:
  • Phone: 415-514-5681
  • Fax:
Mailing address:
  • Phone: 484-862-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberMT221303
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA199397
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: