Healthcare Provider Details

I. General information

NPI: 1740390533
Provider Name (Legal Business Name): MICHAEL DUY CAO P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 05/25/2023
Certification Date: 05/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10900 WARNER AVE SUITE 117
FOUNTAIN VALLEY CA
92708-3846
US

IV. Provider business mailing address

10900 WARNER AVE SUITE 117
FOUNTAIN VALLEY CA
92708-3846
US

V. Phone/Fax

Practice location:
  • Phone: 714-594-3972
  • Fax: 714-582-7071
Mailing address:
  • Phone: 714-594-3972
  • Fax: 714-582-7071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number28743
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: