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General NPI Number Information
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NPI Number | 1225778772
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Entity Type | Individual
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Provider Name | TRACY THANH DAO MD
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Gender | Female
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Dates
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Enumeration Date | 03/31/2022
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 160 E ERIE AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19134-1011
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Country | US
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Telephone | 714-786-9724
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Fax |
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Provider Business Mailing Address
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Address Line | 14912 STARBOARD ST
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City | GARDEN GROVE
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State | CA
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Zip | 92843-5140
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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