Healthcare Provider Details

I. General information

NPI: 1043210354
Provider Name (Legal Business Name): DAVID HOAI CAO PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 E ARTESIA BLVD
LONG BEACH CA
90805-1476
US

IV. Provider business mailing address

13712 OLIVE ST
WESTMINSTER CA
92683-2685
US

V. Phone/Fax

Practice location:
  • Phone: 562-423-3383
  • Fax:
Mailing address:
  • Phone: 714-901-8928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA15404
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: