Provider Demographics
NPI:1194348805
Name:LAI, XUE L (DO)
Entity type:Individual
Prefix:
First Name:XUE
Middle Name:L
Last Name:LAI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:XUELEI
Other - Middle Name:
Other - Last Name:LAI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:450 E HUNTINGTON DR
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3748
Mailing Address - Country:US
Mailing Address - Phone:626-462-1884
Mailing Address - Fax:626-445-1542
Practice Address - Street 1:450 E HUNTINGTON DR
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3748
Practice Address - Country:US
Practice Address - Phone:626-462-1884
Practice Address - Fax:626-445-1542
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-28
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A20476207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program