Provider Demographics
NPI:1285430892
Name:CHEN, XIAO L
Entity type:Individual
Prefix:MS
First Name:XIAO
Middle Name:L
Last Name:CHEN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18109 DARK STAR WAY
Mailing Address - Street 2:
Mailing Address - City:BOYDS
Mailing Address - State:MD
Mailing Address - Zip Code:20841-6100
Mailing Address - Country:US
Mailing Address - Phone:301-538-2754
Mailing Address - Fax:
Practice Address - Street 1:18109 DARK STAR WAY
Practice Address - Street 2:
Practice Address - City:BOYDS
Practice Address - State:MD
Practice Address - Zip Code:20841-6100
Practice Address - Country:US
Practice Address - Phone:301-538-2754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home