Healthcare Provider Details

I. General information

NPI: 1851525281
Provider Name (Legal Business Name): GUI WEN XU N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: WENDY XU N.P.

II. Dates (important events)

Enumeration Date: 05/13/2009
Last Update Date: 11/27/2023
Certification Date: 09/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 S FAIR OAKS AVE SUITE 400
PASADENA CA
91105-2613
US

IV. Provider business mailing address

PO BOX 31309
LOS ANGELES CA
90031-0309
US

V. Phone/Fax

Practice location:
  • Phone: 626-683-9000
  • Fax: 626-568-1224
Mailing address:
  • Phone: 626-683-9000
  • Fax: 626-568-1224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP 14243
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number547299
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: