Individual provider Active NPI

Tina Phuong Dao

  • Pharmacist
  • San Diego, CA
National Provider Identifier
1932340239
Registry record updated Mar 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
61838 Issued in CA
Practice address
4650 Palm Ave
San Diego, CA 92154-8404
Phone
(619) 662-5300
Fax
(619) 662-5317
NPI assigned
Mar 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 61838 CA Primary

Addresses

Primary practice location

4650 Palm Ave
San Diego, CA 92154-8404

Mailing address

10956 Portobelo Dr
San Diego, CA 92124-1181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237161600000",
    "number": "1932340239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10956 PORTOBELO DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921241181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 PALM AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921548404",
            "telephone_number": "619-662-5300",
            "fax_number": "619-662-5317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAO",
        "first_name": "TINA",
        "middle_name": "PHUONG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-16",
        "last_updated": "2009-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "61838",
            "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 Mar 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.