Provider Demographics
NPI:1578134862
Name:DAO, KHANH
Entity Type:Individual
Prefix:
First Name:KHANH
Middle Name:
Last Name:DAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1265 E UNIVERSITY DR APT 2069
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-8448
Mailing Address - Country:US
Mailing Address - Phone:619-278-9178
Mailing Address - Fax:
Practice Address - Street 1:16455 E AVENUE OF THE FOUNTAINS
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-8307
Practice Address - Country:US
Practice Address - Phone:480-770-6990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist