Provider Demographics
NPI:1609078831
Name:XU, CATHY RUIFANG (MD)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:RUIFANG
Last Name:XU
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 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:925-779-7200
Mailing Address - Fax:925-779-7220
Practice Address - Street 1:3901 LONE TREE WAY
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-6200
Practice Address - Country:US
Practice Address - Phone:925-779-7200
Practice Address - Fax:925-779-7220
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101284359208000000X
FLME131841208000000X
CAA115072208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA115072OtherSTATE MEDICAL LICENSE