Provider Demographics
NPI:1407852692
Name:VO, DAI DANG (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAI
Middle Name:DANG
Last Name:VO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1693 FLANIGAN DR
Mailing Address - Street 2:STE 104
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95121-1683
Mailing Address - Country:US
Mailing Address - Phone:408-274-6698
Mailing Address - Fax:408-274-8580
Practice Address - Street 1:1693 FLANIGAN DR
Practice Address - Street 2:STE 104
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95121-1683
Practice Address - Country:US
Practice Address - Phone:408-274-6698
Practice Address - Fax:408-274-8580
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CARPH41403183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSA357540Medicaid