Healthcare Provider Details

I. General information

NPI: 1164195848
Provider Name (Legal Business Name): EXCELL INTEGRATED MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2021
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14023 PARAMOUNT BLVD STE 101
PARAMOUNT CA
90723-2605
US

IV. Provider business mailing address

14023 PARAMOUNT BLVD STE 101
PARAMOUNT CA
90723-2605
US

V. Phone/Fax

Practice location:
  • Phone: 562-331-8881
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KRISTOFFER TOLENTINO CHIN
Title or Position: DO
Credential:
Phone: 562-286-6815