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General NPI Number Information
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NPI Number | 1891589503
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Entity Type | Organization
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Legal Business Name | MEDXCEL GROUP
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Dates
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Enumeration Date | 04/07/2025
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 639 S GLENWOOD PL STE 113
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City | BURBANK
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State | CA
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Zip | 91506-2819
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Country | US
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Telephone | 747-209-0940
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Fax | 818-356-4380
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Provider Business Mailing Address
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Address Line | 25044 PEACHLAND AVE STE 110
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City | NEWHALL
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State | CA
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Zip | 91321-5730
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Country | US
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Telephone | 818-636-6749
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DOMINIQUE DUNN
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Credential | NP
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Telephone | 747-209-0904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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