Provider Demographics
NPI:1679597942
Name:PHAMDO, DANGKHOA (MD)
Entity Type:Individual
Prefix:
First Name:DANGKHOA
Middle Name:
Last Name:PHAMDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 UNIVERSITY PARK
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-4435
Mailing Address - Country:US
Mailing Address - Phone:585-275-1384
Mailing Address - Fax:585-276-0122
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:BOX 604
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-275-1384
Practice Address - Fax:585-276-0122
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA105257207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine