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General NPI Number Information
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NPI Number | 1104283746
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Entity Type | Organization
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Legal Business Name | EXCELLENCE HEALTHCARE MANAGEMENT INC
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Dates
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Enumeration Date | 01/27/2016
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Last Update Date | 01/27/2016
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Provider Practice Location Address
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Address Line | 291 S MAIN ST SUITE G2
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City | YUMA
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State | AZ
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Zip | 85364-1414
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Country | US
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Telephone | 909-801-1424
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Fax |
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Provider Business Mailing Address
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Address Line | 291 S MAIN ST SUITE G2
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City | YUMA
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State | AZ
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Zip | 85364-1414
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Country | US
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Telephone | 909-801-1424
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN
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Name | DR. WILBUR ABALOS PULIDO
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Credential | DBA
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Telephone | 909-801-1424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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