Provider Demographics
NPI:1841871704
Name:XIE, WARREN J
Entity type:Individual
Prefix:
First Name:WARREN
Middle Name:J
Last Name:XIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 W BIRCHCROFT ST
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-5101
Mailing Address - Country:US
Mailing Address - Phone:626-201-0352
Mailing Address - Fax:
Practice Address - Street 1:120 W HELLMAN AVE STE 302
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1209
Practice Address - Country:US
Practice Address - Phone:626-299-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35186-TLG152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation