Provider Demographics
NPI:1790840320
Name:DAO, ANDREW V (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:V
Last Name:DAO
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:PO BOX 1847
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85299-1847
Mailing Address - Country:US
Mailing Address - Phone:480-507-2961
Mailing Address - Fax:
Practice Address - Street 1:428 S GILBERT RD
Practice Address - Street 2:STE 115
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-2263
Practice Address - Country:US
Practice Address - Phone:480-507-2961
Practice Address - Fax:480-507-2971
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94246207L00000X, 207LP2900X
AZ38099207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ350291Medicaid
AZ350291Medicaid
AZZ141527Medicare PIN
AZZ124490Medicare PIN
AZP00670167Medicare PIN
AZP00999812Medicare PIN