Healthcare Provider Details

I. General information

NPI: 1225988116
Provider Name (Legal Business Name): TWO EXECUTIVE GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9047 FLORENCE AVE STE B
DOWNEY CA
90240-3400
US

IV. Provider business mailing address

9047 FLORENCE AVE STE B
DOWNEY CA
90240-3400
US

V. Phone/Fax

Practice location:
  • Phone: 562-291-0559
  • Fax: 310-861-9090
Mailing address:
  • Phone: 562-291-0559
  • Fax: 310-861-9090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code331L00000X
TaxonomyBlood Bank
License Number
License Number State

VIII. Authorized Official

Name: MONIQUE YVONNE WATSON
Title or Position: OWNER
Credential:
Phone: 310-999-9796