Healthcare Provider Details

I. General information

NPI: 1295539518
Provider Name (Legal Business Name): BRIAN XICHONG GU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2025
Last Update Date: 06/07/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

981225 NEBRASKA MEDICAL CTR
OMAHA NE
68198-1225
US

IV. Provider business mailing address

981225 NEBRASKA MEDICAL CTR
OMAHA NE
68198-5575
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-7775
  • Fax:
Mailing address:
  • Phone: 402-559-7775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number10575
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: