Healthcare Provider Details

I. General information

NPI: 1285479667
Provider Name (Legal Business Name): JUSTIN XU NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2024
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S GARFIELD AVE
ALHAMBRA CA
91801-4709
US

IV. Provider business mailing address

9620 FLAIR DR
EL MONTE CA
91731-3005
US

V. Phone/Fax

Practice location:
  • Phone: 626-281-3383
  • Fax: 855-710-5853
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number354195
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95033824
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: