Provider Demographics
NPI:1619198298
Name:DAO, MI (DO)
Entity Type:Individual
Prefix:DR
First Name:MI
Middle Name:
Last Name:DAO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MIMI
Other - Middle Name:
Other - Last Name:DAO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4405 VANDEVER
Mailing Address - Street 2:2ND FLOOR PEDIATRICS
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120
Mailing Address - Country:US
Mailing Address - Phone:619-516-6166
Mailing Address - Fax:619-516-6132
Practice Address - Street 1:4405 VANDEVER
Practice Address - Street 2:2ND FLOOR PEDIATRICS
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120
Practice Address - Country:US
Practice Address - Phone:619-516-6166
Practice Address - Fax:619-516-6132
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9235208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics