| Cao Thi Phuong Dung Md Inc | |
|
6665 Stockton Blvd Suite 8 Sacramento CA 95823 | |
| (916) 428-4118 | |
| (916) 428-5460 |
| Full Name | Cao Thi Phuong Dung Md Inc |
|---|---|
| Speciality | General Practice |
| Location | 6665 Stockton Blvd, Sacramento, California |
| Authorized Official Name and Position | Dung Thi Phuong Cao (DIRECTOR) |
| Authorized Official Contact | 9164284118 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cao Thi Phuong Dung Md Inc Po Box 293839 Sacramento CA 95829 Ph: (916) 428-4118 | Cao Thi Phuong Dung Md Inc 6665 Stockton Blvd Suite 8 Sacramento CA 95823 Ph: (916) 428-4118 |
| NPI Number | 1285711432 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8426947862 |
|---|---|
| Medicare Enrollment ID | O20040312001003 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285711432 | NPI | - | NPPES |
| A619972 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | A61997 (California) | Primary |
| Provider Name | Dung P Cao |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1295812444 PECOS PAC ID: 3577452911 Enrollment ID: I20040317000757 |
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