Healthcare Provider Details

I. General information

NPI: 1235559766
Provider Name (Legal Business Name): HOBBIE CAO LAC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2014
Last Update Date: 04/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1630 OAKLAND RD STE A110
SAN JOSE CA
95131-2461
US

IV. Provider business mailing address

1630 OAKLAND RD STE A110
SAN JOSE CA
95131-2461
US

V. Phone/Fax

Practice location:
  • Phone: 408-260-2458
  • Fax:
Mailing address:
  • Phone: 408-260-2458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberCA 14141
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: