Provider Demographics
NPI:1558351502
Name:CAI, XIAOPANG (DENTIST)
Entity Type:Individual
Prefix:MR
First Name:XIAOPANG
Middle Name:
Last Name:CAI
Suffix:
Gender:M
Credentials:DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:733 NEW HIGH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012
Mailing Address - Country:US
Mailing Address - Phone:213-680-2808
Mailing Address - Fax:626-960-6992
Practice Address - Street 1:733 NEW HIGH
Practice Address - Street 2:SUITE A
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012
Practice Address - Country:US
Practice Address - Phone:213-680-2808
Practice Address - Fax:626-960-6992
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46756122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist