Provider Demographics
NPI:1578601050
Name:CAO, YILI (YILI CAO)
Entity Type:Individual
Prefix:MS
First Name:YILI
Middle Name:
Last Name:CAO
Suffix:
Gender:F
Credentials:YILI CAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 CHRISTOPHER RD
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1312
Mailing Address - Country:US
Mailing Address - Phone:781-890-8688
Mailing Address - Fax:
Practice Address - Street 1:32 SOUTH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-3594
Practice Address - Country:US
Practice Address - Phone:781-891-0670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA345171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist