Provider Demographics
NPI:1275608143
Name:DAO, KHANH V (OD)
Entity Type:Individual
Prefix:DR
First Name:KHANH
Middle Name:V
Last Name:DAO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 S AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-6909
Mailing Address - Country:US
Mailing Address - Phone:714-686-1731
Mailing Address - Fax:650-589-3136
Practice Address - Street 1:451 S AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-6909
Practice Address - Country:US
Practice Address - Phone:650-589-3128
Practice Address - Fax:650-589-3136
Is Sole Proprietor?:No
Enumeration Date:2006-11-23
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12560T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist