Provider Demographics
NPI:1598254906
Name:ZHU, XIAO (MD)
Entity type:Individual
Prefix:
First Name:XIAO
Middle Name:
Last Name:ZHU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 BROCKTON AVE APT 204
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-2761
Mailing Address - Country:US
Mailing Address - Phone:412-334-8201
Mailing Address - Fax:
Practice Address - Street 1:4560 ADMIRALTY WAY STE 256
Practice Address - Street 2:
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-5444
Practice Address - Country:US
Practice Address - Phone:310-846-8457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA195118208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery