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General NPI Number Information
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NPI Number | 1891011953
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Entity Type | Individual
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Provider Name | DANIEL LEE CHAO M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/14/2010
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Last Update Date | 08/28/2017
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Provider Practice Location Address
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Address Line | 9415 CAMPUS POINT DR
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City | LA JOLLA
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State | CA
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Zip | 92093-2604
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Country | US
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Telephone | 858-434-6290
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 232410
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City | SAN DIEGO
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State | CA
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Zip | 92193-2410
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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 | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | A130361
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License Number State | CA
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