Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | A93956 | CA |
N | 207QG0300X | Family Doctor - Geriatric Medicine | A93956 | CA |
NPI | 1184679276 |
---|---|
Provider Name | Daa M Xiao |
First Address | Fresno, CA 93721-1431 |
Second Address | Fresno, CA 93721-1324 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 28/05/2019 |