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General NPI Number Information
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NPI Number | 1134624638
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Entity Type | Organization
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Legal Business Name | DIEM CAO DDS INC
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Dates
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Enumeration Date | 03/27/2018
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Last Update Date | 05/07/2019
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Provider Practice Location Address
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Address Line | 8813 ALONDRA BLVD
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City | PARAMOUNT
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State | CA
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Zip | 90723-4603
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Country | US
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Telephone | 818-383-5350
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Fax |
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Provider Business Mailing Address
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Address Line | 8813 ALONDRA BLVD
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City | PARAMOUNT
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State | CA
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Zip | 90723-4603
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Country | US
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Telephone | 818-383-5350
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. DIEM CAO
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Credential | DDS
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Telephone | 818-383-5350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0112X
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Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DDS101136
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License Number State | CA
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