Provider Demographics
NPI:1295810364
Name:CAO, KELLY CHAU (DC)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:CHAU
Last Name:CAO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KELLY
Other - Middle Name:CHAU
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:9039 BOLSA AVE
Mailing Address - Street 2:SUITE 114
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5572
Mailing Address - Country:US
Mailing Address - Phone:714-899-2255
Mailing Address - Fax:714-899-2215
Practice Address - Street 1:9039 BOLSA AVE
Practice Address - Street 2:SUITE 114
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5572
Practice Address - Country:US
Practice Address - Phone:714-899-2255
Practice Address - Fax:714-899-2215
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27111111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor