Healthcare Provider Details

I. General information

NPI: 1356173827
Provider Name (Legal Business Name): CHRISTINA N CAO PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2024
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7115 NORTHLAND TER N STE 500
BROOKLYN PARK MN
55428-1546
US

IV. Provider business mailing address

1172 W 22ND ST
UPLAND CA
91784-1231
US

V. Phone/Fax

Practice location:
  • Phone: 840-999-0946
  • Fax:
Mailing address:
  • Phone: 818-274-7462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberP11203
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number57888
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: