Provider Demographics
NPI:1023190857
Name:HAN, XIAO-DONG (PHD)
Entity Type:Individual
Prefix:DR
First Name:XIAO-DONG
Middle Name:
Last Name:HAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5755 COTTLE ROAD, BUILDING #6
Mailing Address - Street 2:TPMG REGIONAL GENETICS LABORATORY
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123
Mailing Address - Country:US
Mailing Address - Phone:408-972-3352
Mailing Address - Fax:
Practice Address - Street 1:5755 COTTLE ROAD, BUILDING #6
Practice Address - Street 2:TPMG REGIONAL GENETICS LABORATORY
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123
Practice Address - Country:US
Practice Address - Phone:408-972-3352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2005064207SG0203X
CA2007052207SG0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0203XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Molecular Genetics
No207SG0205XAllopathic & Osteopathic PhysiciansMedical GeneticsPh.D. Medical Genetics