Individual
BAO THAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3393 G ST STE C, MERCED, CA 95340-1001
(209) 580-4172
Mailing address
PO BOX 3768, MERCED, CA 95344-3768
(209) 725-7149
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95028695
CA
Other
Enumeration date
09/25/2024
Last updated
09/27/2024
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