Provider Demographics
NPI:1235665589
Name:LI, JOHN XUELIN (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:XUELIN
Last Name:LI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:13409 GEORGE RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-3064
Mailing Address - Country:US
Mailing Address - Phone:210-429-8922
Mailing Address - Fax:210-479-2010
Practice Address - Street 1:684 HUTCHISON DR
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616
Practice Address - Country:US
Practice Address - Phone:530-297-2330
Practice Address - Fax:210-479-2010
Is Sole Proprietor?:No
Enumeration Date:2017-05-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA187640208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics