Healthcare Provider Details

I. General information

NPI: 1649711912
Provider Name (Legal Business Name): VINH ANH DAO M.D.,PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2017
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 LAS GALLINAS AVE
SAN RAFAEL CA
94903-3410
US

IV. Provider business mailing address

820 LAS GALLINAS AVE
SAN RAFAEL CA
94903-3410
US

V. Phone/Fax

Practice location:
  • Phone: 415-446-2500
  • Fax:
Mailing address:
  • Phone: 415-446-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number156905
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: