Provider Demographics
NPI:1871029462
Name:XUNAN, KEVIN (DO, MPH, CPH)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:
Last Name:XUNAN
Suffix:
Gender:M
Credentials:DO, MPH, CPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 N CIVIC DR APT 175
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-3904
Mailing Address - Country:US
Mailing Address - Phone:510-529-9840
Mailing Address - Fax:
Practice Address - Street 1:421 NUT TREE RD
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687
Practice Address - Country:US
Practice Address - Phone:707-624-7533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-03
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS14790207Q00000X
CA20A16401207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty