Healthcare Provider Details

I. General information

NPI: 1366103764
Provider Name (Legal Business Name): CHRISTOPHER T DAO PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2022
Last Update Date: 01/30/2023
Certification Date: 01/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 GLENSIDE DR STE 101
RICHMOND VA
23226-3769
US

IV. Provider business mailing address

3420 PUMP RD # 246
HENRICO VA
23233-1111
US

V. Phone/Fax

Practice location:
  • Phone: 804-288-3001
  • Fax:
Mailing address:
  • Phone: 804-687-3614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110008717
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: