Healthcare Provider Details

I. General information

NPI: 1568773448
Provider Name (Legal Business Name): XU LONG HE D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2010
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 E CITRUS AVE SUITE A
REDLANDS CA
92374-4270
US

IV. Provider business mailing address

PO BOX 10069
SAN BERNARDINO CA
92423-0069
US

V. Phone/Fax

Practice location:
  • Phone: 949-903-6746
  • Fax:
Mailing address:
  • Phone: 909-793-3311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number5101018920
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number20A12717
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: