Individual provider Active NPI

Robert Vu Cao

  • Physician Assistant
  • Garden Grove, CA
National Provider Identifier
1982162863
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
56641 Issued in CA
Practice address
10707 Lauren Cir
Garden Grove, CA 92840-5012
Phone
(714) 478-4074
NPI assigned
Mar 9, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA56641 CA
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 56641 CA Primary

Addresses

Primary practice location

10707 Lauren Cir
Garden Grove, CA 92840-5012

Mailing address

10707 Lauren Cir
Garden Grove, CA 92840-5012
Phone (714) 478-4074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210408000673 CA Practitioner - Physician Assistant 3870900954 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
56641CAMDPhysician Assistant
PA56641CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Freeport Memorial Hospital Multi-Specialty Past Accepting new patients
Karma TMS PC Multi-Specialty PastSince May 29, 2022 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1552089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1982162863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10707 LAUREN CIR",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928405012",
            "telephone_number": "714-478-4074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10707 LAUREN CIR",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928405012",
            "telephone_number": "714-478-4074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAO",
        "first_name": "ROBERT",
        "middle_name": "VU",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-09",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA56641",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "56641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.