Individual provider Active NPI

Nam Dao, FNP

  • Family Nurse Practitioner
  • Glendora, CA
National Provider Identifier
1285061168
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
23751 Issued in CA
Practice address
1377 S. Grand Ave
Glendora, CA 91740
Phone
(626) 857-2500
NPI assigned
Oct 9, 2013
Last updated
Oct 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 23751 CA Primary

Addresses

Primary practice location

1377 S. Grand Ave
Glendora, CA 91740

Mailing address

16411 McFadden Ave Apt 323
Tustin, CA 92780
Phone (714) 251-1626

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131209001116 CA Practitioner - Nurse Practitioner 5294962742 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of California, Irvine, California College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1893 W Malvern Ave
Fullerton, CA 92833-2403
Phone (714) 278-1024

5475 E la Palma Ave
Anaheim, CA 92807-2075
Phone (714) 279-6088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Current Accepting new patients
Minuteclinic Diagnostic Medical Group of California Inc Family CurrentSince May 11, 2015 Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 17, 2018 Accepting new patients
Cep America - California CurrentSince Oct 5, 2013 Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 17, 2018 Accepting new patients
East Valley Emergency Medical Associates, Inc CurrentSince Oct 1, 2014 Accepting new patients
Mellow Medical Inc a Professional Corporation CurrentSince May 12, 2023 Accepting new patients
Cep America-California CurrentSince Oct 5, 2013 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Mar 21, 2016 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Mar 21, 2016 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Memorial Medical Group Inc Past Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

1401 S Baldwin Ave
Arcadia, CA 91007
Phone (626) 321-4210

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3184

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

1377 S Grand Ave
Glendora, CA 91740
Phone (626) 483-3348

2025 E Route 66
Glendora, CA 91740
Phone (323) 720-1144

25825 Vermont Ave
Harbor City, CA 90710
Phone (310) 325-5111

12301 Wilshire Blvd
Ste 512
Los Angeles, CA 90025
Phone (888) 284-2779

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

525 N Garfield Ave
Monterey Park, CA 91754
Phone (626) 573-2222

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526

438 W Las Tunas Dr
San Gabriel, CA 91776
Phone (626) 289-5454

2514 Berryessa Rd
San Jose, CA 95132
Phone (408) 272-1431

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

8235 Santa Monica Blvd
Ste 302
West Hollywood, CA 90046
Phone (310) 892-4284

2791 Agoura Rd
Westlake Village, CA 91361
Phone (800) 523-4042

9080 Colima Rd
Whittier, CA 90605
Phone (562) 907-1565

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9357/brand/1/csg/1/fhir/r4

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1381276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1285061168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16411 MCFADDEN AVE APT 323",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "92780",
            "telephone_number": "714-251-1626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1377 S. GRAND AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "91740",
            "telephone_number": "626-857-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAO",
        "first_name": "NAM",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-10-09",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "23751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "25825 Vermont Ave",
            "city": "Harbor City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907103518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.