MEDICARE: SI XU

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	171100000X	Acupuncturist	15931	CA

General Provider Information

NPI Number	:	1538578133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SI XU

Provider Business Mailing Address
First Line	:	P.O. BOX 1171
Second Line	:
City	:	MONTEREY PARK
State	:	CA
Zip	:	91754
Country	:	US
Telephone Number	:	626-389-7123
Fax Number	:

Provider Business Practice Location Address
First Line	:	2415 PASADENA AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90031
Country	:	US
Telephone Number	:	626-389-7123
Fax Number	:

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

Provider Enumeration Date	:	08/07/2014
Last Update Date	:	08/07/2014

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Directions to “ SI XU ” Practice Location

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