Provider Demographics
NPI:1447486279
Name:CAO, ANTHONY (DC)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:CAO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17849 BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-7130
Mailing Address - Country:US
Mailing Address - Phone:714-222-7386
Mailing Address - Fax:
Practice Address - Street 1:17849 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-7130
Practice Address - Country:US
Practice Address - Phone:714-222-7386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-08
Last Update Date:2016-10-18
Deactivation Date:2012-02-06
Deactivation Code:
Reactivation Date:2016-09-07
Provider Licenses
StateLicense IDTaxonomies
CA29849111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor