Provider Demographics
NPI:1962761320
Name:XU, JIANMIN (MD)
Entity type:Individual
Prefix:
First Name:JIANMIN
Middle Name:
Last Name:XU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3301 C ST STE 200E
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-3363
Mailing Address - Country:US
Mailing Address - Phone:916-446-0424
Mailing Address - Fax:916-446-9330
Practice Address - Street 1:3301 C ST STE 200E
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-3363
Practice Address - Country:US
Practice Address - Phone:916-446-0424
Practice Address - Fax:916-446-9330
Is Sole Proprietor?:No
Enumeration Date:2012-05-04
Last Update Date:2019-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.35309207ZP0102X
CAA149211207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology