Healthcare Provider Details

I. General information

NPI: 1669996971
Provider Name (Legal Business Name): QUAN HUE CAO MS, RD, CNSC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2017
Last Update Date: 05/11/2021
Certification Date: 05/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 S BASCOM AVE
SAN JOSE CA
95128-2604
US

IV. Provider business mailing address

744 LYNXWOOD CT
SUNNYVALE CA
94086-6557
US

V. Phone/Fax

Practice location:
  • Phone: 408-885-6909
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number960767
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: