Healthcare Provider Details

I. General information

NPI: 1073303129
Provider Name (Legal Business Name): ASIA V CAO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1345 MORRILL AVE
SAN JOSE CA
95132-2224
US

IV. Provider business mailing address

1345 MORRILL AVE
SAN JOSE CA
95132-2224
US

V. Phone/Fax

Practice location:
  • Phone: 408-613-0409
  • Fax:
Mailing address:
  • Phone: 408-613-0409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: