MEDICARE: JIHUA CAO DDS, APC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center	52718	CA

General Provider Information

NPI Number	:	1518119338
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JIHUA CAO DDS, APC

Provider Business Mailing Address
First Line	:	5461 HOLT BLVD STE I
Second Line	:
City	:	MONTCLAIR
State	:	CA
Zip	:	91763-4500
Country	:	US
Telephone Number	:	909-983-6888
Fax Number	:	909-986-4888

Provider Business Practice Location Address
First Line	:	5461 HOLT BLVD STE I
Second Line	:
City	:	MONTCLAIR
State	:	CA
Zip	:	91763-4500
Country	:	US
Telephone Number	:	909-983-6888
Fax Number	:	909-986-4888

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JIHUA CAO
Credential	:
Telephone Number	:	909-983-6888

Provider Enumeration Date	:	10/13/2008
Last Update Date	:	11/07/2012

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