1518071208 NPI number — KHOI M DAO MD

Table of content: KHOI M DAO MD (NPI 1518071208)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518071208 NPI number — KHOI M DAO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DAO
Provider First Name:
KHOI
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518071208
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/19/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
400 N STEPHANIE ST
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
HENDERSON
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89014-6676
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-952-3350
Provider Business Mailing Address Fax Number:
702-952-3364

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10001 S EASTERN AVE
Provider Second Line Business Practice Location Address:
SUITE 108
Provider Business Practice Location Address City Name:
HENDERSON
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89052
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-952-3444
Provider Business Practice Location Address Fax Number:
702-952-3494
Provider Enumeration Date:
08/18/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , with the licence number:  9428 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 002018375 , issued by the state of ( NV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 820000366 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 820000366 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".