Provider Demographics
NPI:1790791945
Name:XU, SHIRLEY XIAOMEI (MD)
Entity Type:Individual
Prefix:DR
First Name:SHIRLEY
Middle Name:XIAOMEI
Last Name:XU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1711 OCEAN PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-4901
Mailing Address - Country:US
Mailing Address - Phone:310-450-4773
Mailing Address - Fax:310-450-0873
Practice Address - Street 1:1711 OCEAN PARK BLVD
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-4901
Practice Address - Country:US
Practice Address - Phone:310-450-4773
Practice Address - Fax:310-450-0873
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA67363207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine