Provider Demographics
NPI:1093194920
Name:XIONG, TOU XIA (PA-C)
Entity Type:Individual
Prefix:
First Name:TOU
Middle Name:XIA
Last Name:XIONG
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 N BEALE RD STE E
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95901-6937
Mailing Address - Country:US
Mailing Address - Phone:530-743-6888
Mailing Address - Fax:
Practice Address - Street 1:14 SUTTERS MILL RD
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965-3269
Practice Address - Country:US
Practice Address - Phone:530-570-3109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-26
Last Update Date:2016-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52465363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant