Provider Demographics
NPI:1295726768
Name:PAO, VICTORIA S (MD)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:S
Last Name:PAO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:20055 LAKE CHABOT RD
Mailing Address - Street 2:SUITE 340
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5331
Mailing Address - Country:US
Mailing Address - Phone:510-537-1577
Mailing Address - Fax:510-537-1436
Practice Address - Street 1:19842 LAKE CHABOT RD
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-4002
Practice Address - Country:US
Practice Address - Phone:510-537-1577
Practice Address - Fax:510-537-1436
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-02
Last Update Date:2021-07-21
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Provider Licenses
StateLicense IDTaxonomies
CAA70717208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI17208Medicare UPIN
CA00A707170Medicare ID - Type UnspecifiedPROVIDER IDENTIFICATION #