Provider Demographics
NPI:1013129113
Name:XU, WEIMIN (MD)
Entity Type:Individual
Prefix:
First Name:WEIMIN
Middle Name:
Last Name:XU
Suffix:
Gender:M
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 846
Mailing Address - Street 2:
Mailing Address - City:DIXON
Mailing Address - State:CA
Mailing Address - Zip Code:95620-0846
Mailing Address - Country:US
Mailing Address - Phone:707-625-1600
Mailing Address - Fax:707-635-1641
Practice Address - Street 1:131 W A ST
Practice Address - Street 2:SUITE 1
Practice Address - City:DIXON
Practice Address - State:CA
Practice Address - Zip Code:95620-3437
Practice Address - Country:US
Practice Address - Phone:707-635-1600
Practice Address - Fax:707-635-1641
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98678207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN06275234OtherECFMG