Provider Demographics
NPI:1134304462
Name:HOME EXCEL PHYSICIAN'S GROUP
Entity Type:Organization
Organization Name:HOME EXCEL PHYSICIAN'S GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CAMILLE
Authorized Official - Middle Name:R
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-633-9572
Mailing Address - Street 1:31854 WRIGHTWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BONSALL
Mailing Address - State:CA
Mailing Address - Zip Code:92003-4216
Mailing Address - Country:US
Mailing Address - Phone:949-633-9572
Mailing Address - Fax:760-414-9758
Practice Address - Street 1:31854 WRIGHTWOOD RD
Practice Address - Street 2:
Practice Address - City:BONSALL
Practice Address - State:CA
Practice Address - Zip Code:92003-4216
Practice Address - Country:US
Practice Address - Phone:949-633-9572
Practice Address - Fax:760-414-9758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-05
Last Update Date:2008-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG80017207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty