Individual
RANDY XIONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3853 ROSECRANS ST, SAN DIEGO, CA 92110-3115
(619) 692-8232
(619) 542-4060
Mailing address
2032 W OLIVE AVE, FULLERTON, CA 92833-3629
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
95050262
CA
164X00000X
Licensed Vocational Nurse
95050262
CA
Other
Enumeration date
11/07/2016
Last updated
11/07/2016
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