Provider Demographics
NPI:1851525281
Name:XU, GUI WEN (NP)
Entity Type:Individual
Prefix:
First Name:GUI
Middle Name:WEN
Last Name:XU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:XU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 31309
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-0309
Mailing Address - Country:US
Mailing Address - Phone:626-683-9000
Mailing Address - Fax:626-568-1224
Practice Address - Street 1:625 S FAIR OAKS AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2613
Practice Address - Country:US
Practice Address - Phone:626-683-9000
Practice Address - Fax:626-568-1224
Is Sole Proprietor?:No
Enumeration Date:2009-05-13
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA547299163W00000X
CANP 14243363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1851525281Medicaid
CA1851525281Medicaid