Provider Demographics
NPI:1487759726
Name:CAO, ANDREW GIAU (OPTICIAN)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:GIAU
Last Name:CAO
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9208 VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-1900
Mailing Address - Country:US
Mailing Address - Phone:626-288-7779
Mailing Address - Fax:626-288-6935
Practice Address - Street 1:9208 VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-1900
Practice Address - Country:US
Practice Address - Phone:626-288-7779
Practice Address - Fax:626-288-6935
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD4141156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4602590001Medicare NSC