Provider Demographics
NPI:1205177862
Name:CAO, TUAN LE (PHARMD)
Entity Type:Individual
Prefix:
First Name:TUAN
Middle Name:LE
Last Name:CAO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 LANCELOT LN
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95127-4162
Mailing Address - Country:US
Mailing Address - Phone:510-987-6622
Mailing Address - Fax:
Practice Address - Street 1:3055 LOUGHBOROUGH DR
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-1119
Practice Address - Country:US
Practice Address - Phone:209-384-1252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-07
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA67061183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist