Provider Demographics
NPI:1720647415
Name:CAO, KAREN MAI (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:MAI
Last Name:CAO
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 FAIR OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-7685
Mailing Address - Country:US
Mailing Address - Phone:916-484-7016
Mailing Address - Fax:916-484-7023
Practice Address - Street 1:2501 FAIR OAKS BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-7685
Practice Address - Country:US
Practice Address - Phone:916-484-7016
Practice Address - Fax:916-484-7023
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54196183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist