MEDICARE: ANGELINE THI DAO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	A371990	CA
2	207N00000X	Dermatology Physician	A371990	CA

General Provider Information

NPI Number	:	1548288822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELINE THI DAO MD

Provider Business Mailing Address
First Line	:	17742 BEACH BLVD STE 301
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-6853
Country	:	US
Telephone Number	:	714-897-7546
Fax Number	:	714-897-7549

Provider Business Practice Location Address
First Line	:	17742 BEACH BLVD STE 301
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-6853
Country	:	US
Telephone Number	:	714-897-7546
Fax Number	:	714-897-7549

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	06/15/2023

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