Provider Demographics
NPI:1457767667
Name:CAO, MINHTAM THI
Entity Type:Individual
Prefix:
First Name:MINHTAM
Middle Name:THI
Last Name:CAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7499 W LAYTON PL
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-6307
Mailing Address - Country:US
Mailing Address - Phone:303-949-3570
Mailing Address - Fax:
Practice Address - Street 1:7499 W LAYTON PL
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-6307
Practice Address - Country:US
Practice Address - Phone:303-949-3570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-08
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16108183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist