Provider Demographics
NPI:1700416674
Name:DAO, ANGELLINE TU ANH
Entity Type:Individual
Prefix:
First Name:ANGELLINE
Middle Name:TU ANH
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 1:2626 W DAHL LN
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-3110
Mailing Address - Country:US
Mailing Address - Phone:714-200-8698
Mailing Address - Fax:
Practice Address - Street 1:9191 WESTMINSTER AVE
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844-2751
Practice Address - Country:US
Practice Address - Phone:714-899-1111
Practice Address - Fax:714-899-2808
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-20
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80839183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist