Provider Demographics
NPI:1255491106
Name:XU, ZHEHUA (MD)
Entity Type:Individual
Prefix:DR
First Name:ZHEHUA
Middle Name:
Last Name:XU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:EDWARD
Other - Middle Name:ZHEHUA
Other - Last Name:XU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:228 N GARFIELD AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1709
Mailing Address - Country:US
Mailing Address - Phone:626-288-3992
Mailing Address - Fax:626-288-3326
Practice Address - Street 1:228 N GARFIELD AVE STE 203
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1709
Practice Address - Country:US
Practice Address - Phone:626-288-3992
Practice Address - Fax:626-288-3326
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71314207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA71314OtherPIN
CA00A713140Medicaid
CAH72400Medicare UPIN
CAA71314OtherPIN