Provider Demographics
NPI:1073684429
Name:XU, LING (MD)
Entity Type:Individual
Prefix:DR
First Name:LING
Middle Name:
Last Name:XU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9615 CROSBY DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-4613
Mailing Address - Country:US
Mailing Address - Phone:510-690-9360
Mailing Address - Fax:510-690-0346
Practice Address - Street 1:20130 LAKE CHABOT RD
Practice Address - Street 2:SUITE #307
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5340
Practice Address - Country:US
Practice Address - Phone:510-690-9360
Practice Address - Fax:510-690-0346
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA69273207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A692730Medicare ID - Type UnspecifiedPPIN
CAH17345Medicare UPIN
CAZZZ28004ZMedicare ID - Type UnspecifiedGROUP ID