Provider Demographics
NPI:1104896513
Name:DAO, SOPHIE K (OD)
Entity type:Individual
Prefix:DR
First Name:SOPHIE
Middle Name:K
Last Name:DAO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:991 MONTAGUE EXPY STE 111
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-6809
Mailing Address - Country:US
Mailing Address - Phone:408-262-1221
Mailing Address - Fax:408-262-0789
Practice Address - Street 1:991 MONTAGUE EXPY STE 111
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-6818
Practice Address - Country:US
Practice Address - Phone:408-262-1221
Practice Address - Fax:408-262-0789
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8213T152W00000X, 152WC0802X, 152WP0200X, 152WS0006X, 152WX0102X, 156FC0800X, 156FC0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
No156FC0800XEye and Vision Services ProvidersTechnician/TechnologistContact Lens
No156FC0801XEye and Vision Services ProvidersTechnician/TechnologistContact Lens Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
12671OtherMEDICAL EYE SERVICES
CASD0082130OtherMEDICAL PROVIDER ID
51733OtherDAVIS VISION
CACA8213OtherEYEMED PROVIDER ID
CASD09818OtherSPECTERA PROVIDER ID
770485005OtherNATIONAL VISION ADMINISTRATORS NETWORK
CASD09818OtherSPECTERA PROVIDER ID