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General NPI Number Information
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NPI Number | 1801791199
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Entity Type | Organization
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Legal Business Name | EXCELENTDX
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Dates
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Enumeration Date | 10/08/2026
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Last Update Date | 10/08/2026
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Provider Practice Location Address
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Address Line | 151 KALMUS DR STE E150
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City | COSTA MESA
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State | CA
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Zip | 92626-7947
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Country | US
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Telephone | 949-500-5513
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Fax |
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Provider Business Mailing Address
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Address Line | 151 KALMUS DR STE E150
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City | COSTA MESA
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State | CA
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Zip | 92626-7947
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Country | US
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Telephone | 949-500-5513
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | BRIAN CHAVEZ
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Credential |
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Telephone | 949-500-5513
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246QL0900X
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Taxonomy Name | Laboratory Management Specialist/Technologist
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License Number |
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License Number State | NULL
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