Healthcare Provider Details

I. General information

NPI: 1497468953
Provider Name (Legal Business Name): SAMANTHA TU NHI CAO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2022
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 W IMPERIAL HWY
BREA CA
92821-3812
US

IV. Provider business mailing address

955 W IMPERIAL HWY
BREA CA
92821-3812
US

V. Phone/Fax

Practice location:
  • Phone: 714-579-6826
  • Fax:
Mailing address:
  • Phone: 714-579-6826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: