Healthcare Provider Details

I. General information

NPI: 1912125543
Provider Name (Legal Business Name): TOAN XUAN CAO MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2359 ULRIC ST
SAN DIEGO CA
92111-6402
US

IV. Provider business mailing address

757 S LINCOLN AVE
EL CAJON CA
92020-6422
US

V. Phone/Fax

Practice location:
  • Phone: 858-268-4933
  • Fax: 858-268-0244
Mailing address:
  • Phone: 619-579-3552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: