Healthcare Provider Details

I. General information

NPI: 1740675776
Provider Name (Legal Business Name): AMY DAO PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2015
Last Update Date: 04/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 S TWIN OAKS VALLEY RD
SAN MARCOS CA
92078-4333
US

IV. Provider business mailing address

306 S TWIN OAKS VALLEY RD
SAN MARCOS CA
92078-4333
US

V. Phone/Fax

Practice location:
  • Phone: 760-891-0618
  • Fax: 760-891-0626
Mailing address:
  • Phone: 760-891-0618
  • Fax: 760-891-0626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number52890
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: