Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | C52961 | CA |
N | 204F00000X | Transplant Surgeon | MD-037728-E | PA |
N | 208200000X | Surgeon | MD037728E | PA |
N | 208600000X | Surgeon | MD037728E | PA |
NPI | 1285635672 |
---|---|
Provider Name | Dai Dao Nghiem |
First Address | Sacramento, CA 95817-2201 |
Second Address | Sacramento, CA 95817-2201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2005 |
Last Update Date | 02/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0010746440001 | (05) | PA |
0165744 | (05) | OH |
0222598000 | (05) | WV |