Provider Demographics
NPI:1124656137
Name:GUAN, YUXI
Entity type:Individual
Prefix:
First Name:YUXI
Middle Name:
Last Name:GUAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-3092
Mailing Address - Country:US
Mailing Address - Phone:831-728-4227
Mailing Address - Fax:831-728-0410
Practice Address - Street 1:1820 MAIN ST
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-3092
Practice Address - Country:US
Practice Address - Phone:831-728-4227
Practice Address - Fax:831-728-0410
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE5950213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist