Provider Demographics
NPI:1790344794
Name:CAO, STEPHANIE QUYNH-HUONG (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:QUYNH-HUONG
Last Name:CAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6655 S CIMARRON RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2181
Mailing Address - Country:US
Mailing Address - Phone:702-916-0434
Mailing Address - Fax:
Practice Address - Street 1:3125 OLD FAIRHAVEN PKWY
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-8266
Practice Address - Country:US
Practice Address - Phone:360-788-8388
Practice Address - Fax:360-788-8389
Is Sole Proprietor?:No
Enumeration Date:2019-06-12
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD61253922207Q00000X
NVLL3261207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine