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General NPI Number Information
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NPI Number | 1538641758
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Entity Type | Individual
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Provider Name | BRUCE XU PHARMD
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Gender | Male
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Dates
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Enumeration Date | 09/04/2018
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Last Update Date | 01/04/2022
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Provider Practice Location Address
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Address Line | 4755 S 44TH PL
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City | PHOENIX
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State | AZ
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Zip | 85040-4016
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Country | US
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Telephone | 866-465-2505
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Fax |
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Provider Business Mailing Address
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Address Line | 1313 N 2ND ST APT 1416
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City | PHOENIX
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State | AZ
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Zip | 85004-1770
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Country | US
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Telephone | 330-421-9681
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | S023478
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License Number State | AZ
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