Provider Demographics
NPI:1326449570
Name:DAO, KHANH MANH TRUNG (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KHANH
Middle Name:MANH TRUNG
Last Name:DAO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1519 S OLIVE AVE
Mailing Address - Street 2:APT 2
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-7100
Mailing Address - Country:US
Mailing Address - Phone:510-852-4480
Mailing Address - Fax:
Practice Address - Street 1:1519 S OLIVE AVE
Practice Address - Street 2:APT 2
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-7100
Practice Address - Country:US
Practice Address - Phone:510-852-4480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS51797183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist