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General NPI Number Information
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NPI Number | 1164195848
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Entity Type | Organization
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Legal Business Name | EXCELL INTEGRATED MEDICAL CORPORATION
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Dates
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Enumeration Date | 07/28/2021
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Last Update Date | 08/16/2021
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Provider Practice Location Address
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Address Line | 14023 PARAMOUNT BLVD STE 101
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City | PARAMOUNT
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State | CA
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Zip | 90723-2605
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Country | US
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Telephone | 562-331-8881
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Fax |
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Provider Business Mailing Address
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Address Line | 14023 PARAMOUNT BLVD STE 101
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City | PARAMOUNT
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State | CA
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Zip | 90723-2605
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | DR. MOHAMMAD SHAHSHAHAN
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Credential | DO
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Telephone | 323-840-5661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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