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NPI Code Detail

MEDICARE: AI T DOAN

MEDICARE: AI T DOAN
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
1124Q00000XDental Hygienist28348CA

General Provider Information

NPI Number : 1740700269
Entity Type Code : Individual
Provider Name (Legal Business Name) : AI T DOAN
Provider Business Mailing Address
First Line : 2670 S WHITE RD STE 200
Second Line :
City : SAN JOSE
State : CA
Zip : 95148-2073
Country : US
Telephone Number : 408-729-4290
Fax Number :
Provider Business Practice Location Address
First Line : 2670 S WHITE RD STE 200
Second Line :
City : SAN JOSE
State : CA
Zip : 95148-2073
Country : US
Telephone Number : 408-729-4290
Fax Number : 408-729-4290
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2017
Last Update Date : 06/26/2017

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Directions to “ AI T DOAN ” Practice Location

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