Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | E5129 | CA |
N | 222Z00000X | Podiatrist | E5129 | CA |
N | 213EP1101X | Primary Podiatric Medicine | E5129 | CA |
N | 111NR0200X | Radiology | E5129 | CA |
N | 213ER0200X | Radiology | E5129 | CA |
N | 2081S0010X | Sports Medicine | E5129 | CA |
N | 213ES0000X | Sports Medicine | E5129 | CA |
Y | 213ES0103X | Foot & Ankle Surgery | E5129 | CA |
NPI | 1154610996 |
---|---|
Provider Name | Dr. Ki Xiong |
First Address | Oroville, CA 95966-6115 |
Second Address | Oroville, CA 95966-6115 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2011 |
Last Update Date | 06/06/2016 |