Active NPI
Khanh Quoc Dao, O.D.
- Optometrist
- Manteca, CA
National Provider Identifier
1992834725
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 11871
- Practice address
- 1205 S Main St
Manteca, CA 95337-5748 - Phone
- (209) 824-2131
- NPI assigned
- Mar 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 11871 | CA | Primary |
Addresses
Primary practice location
1205 S Main St
Manteca, CA 95337-5748
Mailing address
461 McDowell Way
Tracy, CA 95377-8539
Phone (209) 833-8518
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11871 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992834725",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "461 MCDOWELL WAY",
"city": "TRACY",
"state": "CA",
"postal_code": "953778539",
"telephone_number": "209-833-8518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1205 S MAIN ST",
"city": "MANTECA",
"state": "CA",
"postal_code": "953375748",
"telephone_number": "209-824-2131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAO",
"first_name": "KHANH",
"middle_name": "QUOC",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "11871",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manteca, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.