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NPI Code Detail

MEDICARE: XIULI WU PA-C

MEDICARE:   XIULI  WU  PA-C
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
1363AS0400XSurgical Physician AssistantPA20441CA

General Provider Information

NPI Number : 1811120850
Entity Type Code : Individual
Provider Name (Legal Business Name) : XIULI WU PA-C
Provider Business Mailing Address
First Line : 10470 OLD PLACERVILLE RD
Second Line : SUITE 100
City : SACRAMENTO
State : CA
Zip : 95827-2539
Country : US
Telephone Number : 800-470-0071
Fax Number :
Provider Business Practice Location Address
First Line : 4301 X ST
Second Line :
City : SACRAMENTO
State : CA
Zip : 95817-2214
Country : US
Telephone Number : 916-734-2011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2009
Last Update Date : 01/03/2024

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