Healthcare Provider Details

I. General information

NPI: 1003699471
Provider Name (Legal Business Name): MARK CHU XU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2023
Last Update Date: 08/17/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2540 23RD ST BLDG 7
SAN FRANCISCO CA
94143-2500
US

IV. Provider business mailing address

2540 23RD ST BLDG 7
SAN FRANCISCO CA
94143-2500
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-2124
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberA188903
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License NumberA188903
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA188903
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: