Healthcare Provider Details

I. General information

NPI: 1598159345
Provider Name (Legal Business Name): ANTHONY DAO B.S., D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2015
Last Update Date: 11/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14232 RED HILL AVE
TUSTIN CA
92780-5836
US

IV. Provider business mailing address

14232 RED HILL AVE.
TUSTIN CA
92780
US

V. Phone/Fax

Practice location:
  • Phone: 949-326-7679
  • Fax:
Mailing address:
  • Phone: 949-326-7679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number32814
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: