Healthcare Provider Details

I. General information

NPI: 1992005102
Provider Name (Legal Business Name): XIN LING LAO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2010
Last Update Date: 12/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 N DOUTY ST
HANFORD CA
93230-3722
US

IV. Provider business mailing address

1025 N DOUTY ST
HANFORD CA
93230-3722
US

V. Phone/Fax

Practice location:
  • Phone: 559-583-2254
  • Fax: 559-583-2195
Mailing address:
  • Phone: 559-583-2254
  • Fax: 559-583-2195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA116027
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: