Healthcare Provider Details

I. General information

NPI: 1982093670
Provider Name (Legal Business Name): CHUA MELINDA XIONG RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2015
Last Update Date: 10/04/2025
Certification Date: 10/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34800 BOB WILSON DR
SAN DIEGO CA
92134-2205
US

IV. Provider business mailing address

11896 PASEO LUCIDO UNIT 126
SAN DIEGO CA
92128-6260
US

V. Phone/Fax

Practice location:
  • Phone: 559-800-5088
  • Fax:
Mailing address:
  • Phone: 916-678-1665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number31904
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number0117006952
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: