Healthcare Provider Details

I. General information

NPI: 1215457130
Provider Name (Legal Business Name): JORDAN XU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2017
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SOUTH MANCHESTER SUITE 210 -2ND FLOOR
ORANGE CA
92868
US

IV. Provider business mailing address

200 S MANCHESTER AVE STE 210-2ND
ORANGE CA
92868-3217
US

V. Phone/Fax

Practice location:
  • Phone: 626-236-3844
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberA161748
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: