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General NPI Number Information
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NPI Number | 1295812444
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Entity Type | Individual
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Provider Name | DUNG THI PHUONG CAO MD
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Gender | Female
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 11/21/2011
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Provider Practice Location Address
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Address Line | 6665 STOCKTON BLVD SUITE 8
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City | SACRAMENTO
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State | CA
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Zip | 95823
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Country | US
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Telephone | 916-428-4118
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Fax | 916-428-5460
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Provider Business Mailing Address
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Address Line | PO BOX 293839
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City | SACRAMENTO
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State | CA
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Zip | 95829
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Country | US
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Telephone | 916-428-4118
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Fax | 916-428-5460
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A61997
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License Number State | CA
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