MEDICARE: MR. DAVID HOAI CAO PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	PA15404	CA

General Provider Information

NPI Number	:	1043210354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID HOAI CAO PA-C

Provider Business Mailing Address
First Line	:	13712 OLIVE ST
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-2685
Country	:	US
Telephone Number	:	714-901-8928
Fax Number	:

Provider Business Practice Location Address
First Line	:	540 E ARTESIA BLVD
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-1476
Country	:	US
Telephone Number	:	562-423-3383
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	07/08/2007

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