Provider Demographics
NPI:1538441720
Name:DAO, JOHN TRUNGTHU (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:TRUNGTHU
Last Name:DAO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:18567 CALLENS CIR
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-6622
Mailing Address - Country:US
Mailing Address - Phone:714-963-5306
Mailing Address - Fax:661-823-0742
Practice Address - Street 1:1101 W TEHACHAPI BLVD
Practice Address - Street 2:
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561-2559
Practice Address - Country:US
Practice Address - Phone:661-823-0163
Practice Address - Fax:661-823-0742
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH64673183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist