Healthcare Provider Details

I. General information

NPI: 1881701639
Provider Name (Legal Business Name): HELEN XU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 08/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11370 ANDERSON ST SUITE 2100
LOMA LINDA CA
92354-3450
US

IV. Provider business mailing address

11370 ANDERSON ST SUITE 2100
LOMA LINDA CA
92354-3450
US

V. Phone/Fax

Practice location:
  • Phone: 909-558-2126
  • Fax: 909-558-2401
Mailing address:
  • Phone: 909-558-2126
  • Fax: 909-558-2401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberA83955
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: