Individual
JESSICA LELY CAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16500 VENTURA BLVD STE 250, ENCINO, CA 91436-2018
(818) 788-9333
Mailing address
16500 VENTURA BLVD STE 250, ENCINO, CA 91436-2018
(818) 788-9333
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
57.029111
OH
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
A177288
CA
Other
Enumeration date
04/18/2016
Last updated
01/17/2023
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