Provider Demographics
NPI: | 1306136726 |
---|---|
Name: | LU, XIAOYING (MD) |
Entity type: | Individual |
Prefix: | |
First Name: | XIAOYING |
Middle Name: | |
Last Name: | LU |
Suffix: | |
Gender: | F |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 11201 BENTON ST |
Mailing Address - Street 2: | |
Mailing Address - City: | LOMA LINDA |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 92357-0001 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 11201 BENTON ST |
Practice Address - Street 2: | |
Practice Address - City: | LOMA LINDA |
Practice Address - State: | CA |
Practice Address - Zip Code: | 92357-3201 |
Practice Address - Country: | US |
Practice Address - Phone: | 909-825-7084 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2011-04-19 |
Last Update Date: | 2025-03-25 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | A129062 | 2084N0400X, 2084N0600X, 2084E0001X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 2084E0001X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Epilepsy | Group - Multi-Specialty |
No | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |
No | 2084N0600X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Clinical Neurophysiology | Group - Multi-Specialty |