Healthcare Provider Details

I. General information

NPI: 1598953689
Provider Name (Legal Business Name): YING CAO M.D., PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2007
Last Update Date: 08/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 S KING ST
HONOLULU HI
96813-3097
US

IV. Provider business mailing address

33 LANIHULI ST
HILO HI
96720-4142
US

V. Phone/Fax

Practice location:
  • Phone: 808-522-3829
  • Fax:
Mailing address:
  • Phone: 808-961-4708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number036117180
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number14698
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: