Provider Demographics
NPI:1295358000
Name:WU-MA, XIU MIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:XIU MIN
Middle Name:
Last Name:WU-MA
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 1:25363 PARKLANE DR
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-3175
Mailing Address - Country:US
Mailing Address - Phone:702-290-3332
Mailing Address - Fax:
Practice Address - Street 1:6877 SEBASTOPOL AVE
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-3416
Practice Address - Country:US
Practice Address - Phone:707-823-7209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV20381183500000X
CA82305183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist