Provider Demographics
NPI:1902191083
Name:LI, XIN (MD)
Entity Type:Individual
Prefix:
First Name:XIN
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3094
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98073-3094
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:425-494-5996
Practice Address - Street 1:555 MARKET ST FL 13
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94105-2806
Practice Address - Country:US
Practice Address - Phone:855-527-1850
Practice Address - Fax:650-360-0447
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA131259207R00000X
WAMD61294207207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine