Healthcare Provider Details

I. General information

NPI: 1144051673
Provider Name (Legal Business Name): WENQIANG CAO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2024
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8410 FARM RD
LAS VEGAS NV
89131-8158
US

IV. Provider business mailing address

5125 ESPOSITO AVE
LAS VEGAS NV
89141-3832
US

V. Phone/Fax

Practice location:
  • Phone: 702-658-2030
  • Fax:
Mailing address:
  • Phone: 702-882-5982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number24280
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: