Provider Demographics
NPI:1114461332
Name:CAO, THAO (RPH)
Entity Type:Individual
Prefix:
First Name:THAO
Middle Name:
Last Name:CAO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3356 FARTHING WAY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95132-1908
Mailing Address - Country:US
Mailing Address - Phone:503-887-3344
Mailing Address - Fax:
Practice Address - Street 1:3356 FARTHING WAY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95132-1908
Practice Address - Country:US
Practice Address - Phone:503-887-3344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA75981183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist