Provider Demographics
NPI:1275803868
Name:EXCELLENCE PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:EXCELLENCE PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:714-705-5372
Mailing Address - Street 1:9191 WESTMINSTER AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92844-2751
Mailing Address - Country:US
Mailing Address - Phone:714-705-5372
Mailing Address - Fax:714-530-7760
Practice Address - Street 1:9191 WESTMINSTER AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844-2751
Practice Address - Country:US
Practice Address - Phone:714-705-5372
Practice Address - Fax:714-530-7760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-12
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty