Provider Demographics
NPI:1679011571
Name:CAO, TUAN NGOC (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TUAN
Middle Name:NGOC
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 1:12100 EUCLID ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92840-3304
Mailing Address - Country:US
Mailing Address - Phone:714-741-3430
Mailing Address - Fax:714-741-9595
Practice Address - Street 1:12100 EUCLID ST
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-3304
Practice Address - Country:US
Practice Address - Phone:714-741-3430
Practice Address - Fax:714-741-9595
Is Sole Proprietor?:No
Enumeration Date:2017-02-10
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49636183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist