Provider Demographics
NPI:1518090810
Name:CAO, HANBIAO (LAC)
Entity Type:Individual
Prefix:
First Name:HANBIAO
Middle Name:
Last Name:CAO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10249 TUSCANY RD
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-2107
Mailing Address - Country:US
Mailing Address - Phone:443-325-7671
Mailing Address - Fax:443-325-7671
Practice Address - Street 1:4801 DORSEY HALL DR
Practice Address - Street 2:SUITE 212
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7766
Practice Address - Country:US
Practice Address - Phone:410-715-0200
Practice Address - Fax:410-715-4696
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01217171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist