Healthcare Provider Details

I. General information

NPI: 1235526203
Provider Name (Legal Business Name): PETER ZIHAO XU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2015
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 E BADILLO ST
COVINA CA
91723-2116
US

IV. Provider business mailing address

235 E BADILLO ST
COVINA CA
91723-2116
US

V. Phone/Fax

Practice location:
  • Phone: 626-793-2885
  • Fax: 626-915-4700
Mailing address:
  • Phone: 626-793-2885
  • Fax: 626-214-7815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA144203
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: