Healthcare Provider Details

I. General information

NPI: 1104743996
Provider Name (Legal Business Name): YANG XIE HEALTHCARE INCORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 S ATLANTIC BLVD STE 108
MONTEREY PARK CA
91754-3243
US

IV. Provider business mailing address

328 S ATLANTIC BLVD STE 108
MONTEREY PARK CA
91754-3243
US

V. Phone/Fax

Practice location:
  • Phone: 626-795-8893
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DIANA XIE
Title or Position: CEO
Credential:
Phone: 626-795-8893