Provider Demographics
NPI:1760801807
Name:XU, DELI (LAC)
Entity Type:Individual
Prefix:MR
First Name:DELI
Middle Name:
Last Name:XU
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13362 NEWPORT AVE STE F
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3427
Mailing Address - Country:US
Mailing Address - Phone:626-314-9006
Mailing Address - Fax:
Practice Address - Street 1:13362 NEWPORT AVE STE F
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3427
Practice Address - Country:US
Practice Address - Phone:626-225-6486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-15
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15875171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist