Healthcare Provider Details

I. General information

NPI: 1285210633
Provider Name (Legal Business Name): WILSON XUAN MAI MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 LAWRENCE EXPY
SANTA CLARA CA
95051-5173
US

IV. Provider business mailing address

710 LAWRENCE EXPY DEPT 384
SANTA CLARA CA
95051-5173
US

V. Phone/Fax

Practice location:
  • Phone: 408-851-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberA179877
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: