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General NPI Number Information
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NPI Number | 1598254906
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Entity Type | Individual
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Provider Name | XIAO ZHU M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/02/2018
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 4560 ADMIRALTY WAY STE 256
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City | MARINA DEL REY
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State | CA
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Zip | 90292-5444
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Country | US
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Telephone | 310-846-8457
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Fax |
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Provider Business Mailing Address
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Address Line | 1540 BROCKTON AVE APT 204
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City | LOS ANGELES
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State | CA
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Zip | 90025-2761
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Country | US
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Telephone | 412-334-8201
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 195118
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License Number State | CA
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