Healthcare Provider Details

I. General information

NPI: 1548488877
Provider Name (Legal Business Name): MICHAEL K. CAO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 10/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8729 VALLEY BLVD UNIT A
ROSEMEAD CA
91770-1743
US

IV. Provider business mailing address

8729 VALLEY BLVD UNIT A
ROSEMEAD CA
91770-1743
US

V. Phone/Fax

Practice location:
  • Phone: 626-451-0086
  • Fax: 626-451-0089
Mailing address:
  • Phone: 626-451-0086
  • Fax: 626-451-0089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA80802
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberA80802
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA80802
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: