Healthcare Provider Details

I. General information

NPI: 1932786258
Provider Name (Legal Business Name): DANIEL MOK DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 09/07/2023
Certification Date: 09/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 RAINBOW BLVD # MS 1046
KANSAS CITY KS
66160-8500
US

IV. Provider business mailing address

3901 RAINBOW BLVD # MS 1046
KANSAS CITY KS
66160-8500
US

V. Phone/Fax

Practice location:
  • Phone: 502-608-9257
  • Fax:
Mailing address:
  • Phone: 502-608-9257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number94-10852
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: