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General NPI Number Information
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NPI Number | 1902254147
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Entity Type | Organization
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Legal Business Name | MOSAIC EYE SPECIALISTS, PC
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Dates
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Enumeration Date | 05/27/2016
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Last Update Date | 06/26/2023
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Provider Practice Location Address
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Address Line | 3555 ROSECRANS ST STE 107B
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City | SAN DIEGO
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State | CA
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Zip | 92110-3232
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Country | US
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Telephone | 619-226-1877
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Fax | 619-226-0482
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Provider Business Mailing Address
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Address Line | 3555 ROSECRANS ST STE 107B
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City | SAN DIEGO
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State | CA
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Zip | 92110-3232
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Country | US
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Telephone | 619-226-1877
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Fax | 619-226-0482
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ADAM DAO
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Credential | MD
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Telephone | 619-226-1877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A136640
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License Number State | CA
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