Healthcare Provider Details

I. General information

NPI: 1346542008
Provider Name (Legal Business Name): YUN ANNA CAO D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2010
Last Update Date: 11/04/2021
Certification Date: 11/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4950 W SUNSET BLVD FL 4
LOS ANGELES CA
90027-5822
US

IV. Provider business mailing address

1640 E MOBECK ST
WEST COVINA CA
91791-2628
US

V. Phone/Fax

Practice location:
  • Phone: 800-954-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A11407
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: