Healthcare Provider Details

I. General information

NPI: 1801224738
Provider Name (Legal Business Name): JESSICA DAO PHARM. D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2013
Last Update Date: 11/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62 MADEIRA CT
STANTON CA
90680-3189
US

IV. Provider business mailing address

62 MADEIRA CT
STANTON CA
90680-3189
US

V. Phone/Fax

Practice location:
  • Phone: 206-778-0759
  • Fax:
Mailing address:
  • Phone: 206-778-0759
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number69961
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: