Healthcare Provider Details

I. General information

NPI: 1447486279
Provider Name (Legal Business Name): ANTHONY CAO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2009
Last Update Date: 10/18/2016
Certification Date:
Deactivation Date: 02/06/2012
Reactivation Date: 09/07/2016

III. Provider practice location address

17849 BEACH BLVD
HUNTINGTON BEACH CA
92647-7130
US

IV. Provider business mailing address

17849 BEACH BLVD
HUNTINGTON BEACH CA
92647-7130
US

V. Phone/Fax

Practice location:
  • Phone: 714-222-7386
  • Fax:
Mailing address:
  • Phone: 714-222-7386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number29849
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: