Provider Demographics
NPI:1558548552
Name:MAO, CHHY (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHHY
Middle Name:
Last Name:MAO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 KING ST
Mailing Address - Street 2:APT 636
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94158-1606
Mailing Address - Country:US
Mailing Address - Phone:617-480-5040
Mailing Address - Fax:
Practice Address - Street 1:1900 WEBSTER ST
Practice Address - Street 2:SUITE A
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-2946
Practice Address - Country:US
Practice Address - Phone:510-834-4321
Practice Address - Fax:510-834-4323
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA564731223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics