Healthcare Provider Details

I. General information

NPI: 1659469997
Provider Name (Legal Business Name): XATIS CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 10/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21081 S WESTERN AVE SUITE # 195
TORRANCE CA
90501-1703
US

IV. Provider business mailing address

21081 S WESTERN AVE SUITE # 195
TORRANCE CA
90501-1703
US

V. Phone/Fax

Practice location:
  • Phone: 310-328-0213
  • Fax: 310-328-9068
Mailing address:
  • Phone: 310-328-0213
  • Fax: 310-328-9068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: MR. PETER J. DELELLIS
Title or Position: PRESIDENT
Credential:
Phone: 310-328-0213