MEDICARE: DAITRANG DO

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	183500000X	Pharmacist	17144	NV

General Provider Information

NPI Number	:	1619257334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAITRANG DO

Provider Business Mailing Address
First Line	:	3765 LAS VEGAS BLVD S
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-4320
Country	:	US
Telephone Number	:	702-739-9645
Fax Number	:	702-739-9687

Provider Business Practice Location Address
First Line	:	3765 LAS VEGAS BLVD S
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-4320
Country	:	US
Telephone Number	:	702-739-9645
Fax Number	:	702-739-9687

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

Provider Enumeration Date	:	08/25/2011
Last Update Date	:	08/25/2011

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Directions to “ DAITRANG DO ” Practice Location

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