Provider Demographics
NPI:1528208626
Name:DAO, TUONG-VAN T (HHP)
Entity Type:Individual
Prefix:
First Name:TUONG-VAN
Middle Name:T
Last Name:DAO
Suffix:
Gender:F
Credentials:HHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30347 SANTA CECILIA DR
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-3211
Mailing Address - Country:US
Mailing Address - Phone:760-888-7099
Mailing Address - Fax:270-675-9217
Practice Address - Street 1:30347 SANTA CECILIA DR
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-3211
Practice Address - Country:US
Practice Address - Phone:760-888-7099
Practice Address - Fax:270-675-9217
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
173C00000X, 175F00000X
CAABMP # 875997207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No173C00000XOther Service ProvidersReflexologist
No175F00000XOther Service ProvidersNaturopath