Healthcare Provider Details

I. General information

NPI: 1689694689
Provider Name (Legal Business Name): HUY NGOC DAO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 05/13/2021
Certification Date: 05/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1199 DELBON AVE STE 5
TURLOCK CA
95382-2006
US

IV. Provider business mailing address

2150 COLORADO AVE
TURLOCK CA
95382-2003
US

V. Phone/Fax

Practice location:
  • Phone: 209-656-0183
  • Fax: 209-656-0199
Mailing address:
  • Phone: 209-656-0183
  • Fax: 209-656-0199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number20A9483
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: