Provider Demographics
NPI:1558848986
Name:JUDY CAO, OD, INC
Entity Type:Organization
Organization Name:JUDY CAO, OD, INC
Other - Org Name:VIZEN OPTOMETRIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:CAO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:626-239-5332
Mailing Address - Street 1:1021 S PINE ST
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-3136
Mailing Address - Country:US
Mailing Address - Phone:626-239-5332
Mailing Address - Fax:
Practice Address - Street 1:360 E LAS TUNAS DR UNIT 203
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1502
Practice Address - Country:US
Practice Address - Phone:626-239-5332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-27
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1396153508Medicaid