Provider Demographics
NPI:1275257339
Name:XIONG, PA (PHARMD)
Entity Type:Individual
Prefix:
First Name:PA
Middle Name:
Last Name:XIONG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1794 ASHLAN AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-5190
Mailing Address - Country:US
Mailing Address - Phone:559-294-6600
Mailing Address - Fax:559-294-6607
Practice Address - Street 1:1794 ASHLAN AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-5190
Practice Address - Country:US
Practice Address - Phone:559-294-6600
Practice Address - Fax:559-294-6607
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85723183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist