MEDICARE: KUW XIONG P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	20718	CA

General Provider Information

NPI Number	:	1245568534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KUW XIONG P.A.

Provider Business Mailing Address
First Line	:	2590 PINEDALE AVE
Second Line	:
City	:	MERCED
State	:	CA
Zip	:	95348-3803
Country	:	US
Telephone Number	:	215-589-8254
Fax Number	:

Provider Business Practice Location Address
First Line	:	1908 N BEALE RD
Second Line	:
City	:	MARYSVILLE
State	:	CA
Zip	:	95901-6937
Country	:	US
Telephone Number	:	530-743-6888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/24/2009
Last Update Date	:	11/24/2009

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