Provider Demographics
NPI:1902030190
Name:XU, YUJIE (MD, PHD)
Entity Type:Individual
Prefix:
First Name:YUJIE
Middle Name:
Last Name:XU
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 HOPE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-2512
Mailing Address - Country:US
Mailing Address - Phone:310-227-9485
Mailing Address - Fax:
Practice Address - Street 1:3030 OLD RANCH PKWY STE 430
Practice Address - Street 2:
Practice Address - City:SEAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:90740-2760
Practice Address - Country:US
Practice Address - Phone:562-799-8900
Practice Address - Fax:562-799-8901
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-04
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA106274207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology