Healthcare Provider Details

I. General information

NPI: 1710489778
Provider Name (Legal Business Name): XELNT INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2018
Last Update Date: 03/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16270 CADMIUM CT
CHINO HILLS CA
91709-4615
US

IV. Provider business mailing address

16270 CADMIUM CT
CHINO HILLS CA
91709-4615
US

V. Phone/Fax

Practice location:
  • Phone: 909-203-9763
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: SONNY PATEL
Title or Position: CEO
Credential:
Phone: 909-203-9763