Provider Demographics
NPI:1134200165
Name:DAO, NINA H
Entity type:Individual
Prefix:DR
First Name:NINA
Middle Name:H
Last Name:DAO
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:NINA
Other - Middle Name:H
Other - Last Name:HA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:22 ARRIVO DR
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-5118
Mailing Address - Country:US
Mailing Address - Phone:714-614-0317
Mailing Address - Fax:949-443-3828
Practice Address - Street 1:31401 RANCHO VIEJO RD
Practice Address - Street 2:SUITE 103
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-1851
Practice Address - Country:US
Practice Address - Phone:949-248-2590
Practice Address - Fax:949-443-3828
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11797T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU88183Medicare UPIN