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General NPI Number Information
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NPI Number | 1689026700
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Entity Type | Organization
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Legal Business Name | EXCELLENT HEALTHCARE MANAGEMENT INC
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Dates
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Enumeration Date | 07/13/2016
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Last Update Date | 07/13/2016
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Provider Practice Location Address
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Address Line | 1788 S SAN GABRIEL BLVD STE 201
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City | SAN GABRIEL
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State | CA
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Zip | 91776-3978
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Country | US
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Telephone | 626-307-0550
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Fax | 626-307-1892
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Provider Business Mailing Address
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Address Line | 1788 S SAN GABRIEL BLVD STE 201
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City | SAN GABRIEL
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State | CA
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Zip | 91776-3978
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Country | US
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Telephone | 626-307-0550
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Fax | 626-307-1892
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. TIN Y. YUNG
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Credential | M.D.
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Telephone | 626-307-0550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | G61730
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License Number State | CA
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