Healthcare Provider Details

I. General information

NPI: 1811398712
Provider Name (Legal Business Name): CATHY XU MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2014
Last Update Date: 09/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4646 N 1ST ST STE 102
FRESNO CA
93726-0973
US

IV. Provider business mailing address

4646 N 1ST ST STE 102
FRESNO CA
93726-0973
US

V. Phone/Fax

Practice location:
  • Phone: 559-226-4646
  • Fax: 559-227-4646
Mailing address:
  • Phone: 559-226-4646
  • Fax: 559-227-4646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: CATHY RUIFANG XU
Title or Position: PRESIDENT
Credential: MD
Phone: 559-375-5774