Organization Active NPI

Viet Trong Dao MD a Professional Medical Corporation

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1902177066
Registry record updated Jan 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VIET TRONG DAO MD A PROFESSIONAL MEDICAL CORPORATION
Practice address
6255 University Ave
Ste a-2
San Diego, CA 92115-5727
Phone
(619) 583-0553
Fax
(619) 583-5702
NPI assigned
Jan 21, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2012

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

Authorized official

Name
Viet T Dao, MDNPI 1861406225
Title
Owner
Phone
(619) 583-0553

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

6255 University Ave
Ste a-2
San Diego, CA 92115-5727

Mailing address

6255 University Ave
Ste a-2
San Diego, CA 92115-5727
Phone (619) 583-0553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120404000317 CA Part B Supplier - Clinic/Group Practice 6204096928 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

6255 University Ave
Ste A2
San Diego, CA 92115
Phone (619) 583-0553

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1327104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327104000000",
    "number": "1902177066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 UNIVERSITY AVE",
            "address_2": "STE A-2",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921155727",
            "telephone_number": "619-583-0553",
            "fax_number": "619-583-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6255 UNIVERSITY AVE",
            "address_2": "STE A-2",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921155727",
            "telephone_number": "619-583-0553",
            "fax_number": "619-583-5702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIET TRONG DAO MD A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-21",
        "last_updated": "2012-01-21",
        "status": "A",
        "authorized_official_last_name": "DAO",
        "authorized_official_first_name": "VIET",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-583-0553",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.