Provider Demographics
NPI:1154966091
Name:CAO, MARA TA (MD)
Entity type:Individual
Prefix:
First Name:MARA
Middle Name:TA
Last Name:CAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1580 VALENCIA ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-4423
Mailing Address - Country:US
Mailing Address - Phone:415-600-5400
Mailing Address - Fax:415-369-1397
Practice Address - Street 1:1580 VALENCIA STREET LEVEL 3
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110
Practice Address - Country:US
Practice Address - Phone:415-600-5400
Practice Address - Fax:415-369-1397
Is Sole Proprietor?:No
Enumeration Date:2019-11-14
Last Update Date:2025-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA194823207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine