Individual
DAT THANH DO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1540 FLORIDA AVE STE 100, MODESTO, CA 95350-4430
(209) 577-5557
(209) 579-7246
Mailing address
1540 FLORIDA AVE STE 100, MODESTO, CA 95350-4430
(209) 577-5557
(209) 579-7246
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A76728
CA
207RC0000X
Cardiovascular Disease Physician
M1639
TX
207RI0011X
Interventional Cardiology Physician
Primary
A76728
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
199673801
—
TX
01
—
199673802
CSHCN
TX
01
—
8BW903
BCBS
TX
Enumeration date
09/15/2006
Last updated
01/15/2021
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