Healthcare Provider Details

I. General information

NPI: 1316416670
Provider Name (Legal Business Name): PSYCHIATRIC EXCELLENCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2018
Last Update Date: 05/31/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12700 INGLEWOOD AVE UNIT 62
HAWTHORNE CA
90251-2407
US

IV. Provider business mailing address

12700 INGLEWOOD AVE UNIT 62
HAWTHORNE CA
90251-2407
US

V. Phone/Fax

Practice location:
  • Phone: 858-386-2322
  • Fax: 415-854-9551
Mailing address:
  • Phone: 858-386-2322
  • Fax: 415-854-9551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: ANURAG GOEL
Title or Position: OWNER
Credential:
Phone: 858-386-2322