Healthcare Provider Details

I. General information

NPI: 1467964841
Provider Name (Legal Business Name): HEALTH EXCEL HOME CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2017
Last Update Date: 10/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9850 GENESEE AVE STE 900
LA JOLLA CA
92037-1220
US

IV. Provider business mailing address

9850 GENESEE AVE STE 900
LA JOLLA CA
92037-1220
US

V. Phone/Fax

Practice location:
  • Phone: 858-452-1279
  • Fax: 858-587-1642
Mailing address:
  • Phone: 858-452-1279
  • Fax: 858-587-1642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TERESA MESERVE
Title or Position: ADMINISTRATOR DESIGNEE
Credential:
Phone: 858-452-1279