Healthcare Provider Details

I. General information

NPI: 1861175325
Provider Name (Legal Business Name): KASSIE KAO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2023
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 CAMPUS DR
DALY CITY CA
94015-4900
US

IV. Provider business mailing address

901 CAMPUS DR STE 210
DALY CITY CA
94015-4930
US

V. Phone/Fax

Practice location:
  • Phone: 650-993-6300
  • Fax:
Mailing address:
  • Phone: 650-993-6300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number67510
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: