Healthcare Provider Details

I. General information

NPI: 1124608229
Provider Name (Legal Business Name): ANDREW YANG XIAO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 LAWRENCE EXPY DEPT 204
SANTA CLARA CA
95051-5173
US

IV. Provider business mailing address

700 LAWRENCE EXPY DEPT 204
SANTA CLARA CA
95051-5173
US

V. Phone/Fax

Practice location:
  • Phone: 669-288-1846
  • Fax:
Mailing address:
  • Phone: 669-288-1846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberA191461
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: