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General NPI Number Information
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NPI Number | 1174063218
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Entity Type | Organization
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Legal Business Name | XCELL SPORTS AND REGENERATIVE MEDICINE INC
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Dates
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Enumeration Date | 03/07/2017
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Last Update Date | 08/08/2017
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Provider Practice Location Address
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Address Line | 6125 PASEO DEL NORTE SUITE 100
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City | CARLSBAD
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State | CA
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Zip | 92011-1112
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Country | US
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Telephone | 760-909-2355
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Fax |
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Provider Business Mailing Address
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Address Line | 6125 PASEO DEL NORTE SUITE 100
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City | CARLSBAD
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State | CA
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Zip | 92011-1112
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Country | US
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Telephone | 760-909-2355
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | CHRISTOPHER J ROGERS
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Credential | MD
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Telephone | 760-909-2355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | G84249
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License Number State | CA
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