Provider Demographics
NPI:1982954616
Name:MX MED INC
Entity Type:Organization
Organization Name:MX MED INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MING
Authorized Official - Middle Name:
Authorized Official - Last Name:XI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-203-9982
Mailing Address - Street 1:P.O. BOX 6823
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91802-6823
Mailing Address - Country:US
Mailing Address - Phone:626-203-9982
Mailing Address - Fax:
Practice Address - Street 1:103 N GARFIELD AVE
Practice Address - Street 2:#F
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3555
Practice Address - Country:US
Practice Address - Phone:626-203-9982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-10
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2084P0800X
CAA119702208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty