Provider Demographics
NPI:1760831242
Name:CAO, JOHN THANH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:THANH
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 1:5590 W GAIL DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-1226
Mailing Address - Country:US
Mailing Address - Phone:480-321-9825
Mailing Address - Fax:
Practice Address - Street 1:5590 W GAIL DR
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-1226
Practice Address - Country:US
Practice Address - Phone:480-321-9825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-06
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS022162183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist