# DEPARTMENT OF VETERANS AFFAIRS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023236577
- **Authorized official:** DR. YAN CAO M.D. (STAFF PHSICIAN)
- **Authorized official phone:** (901) 523-8990

## Contact information

- **Practice address:** 1030 JEFFERSON AVE, MEMPHIS, TN 38104-2127
- **Practice address phone:** (901) 523-8990
- **Mailing address:** 1030 JEFFERSON AVE, MEMPHIS, TN 38104-2127
- **Mailing address phone:** (901) 523-8990

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QV0200X | VA Clinic/Center | 42791 | TN | Yes |

## Other

- **Enumeration date:** 04/22/2007
- **Last updated:** 06/30/2008