Provider Demographics
NPI:1184170458
Name:EXCEL MEDICINE INC
Entity type:Organization
Organization Name:EXCEL MEDICINE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAILENDER
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:669-333-9995
Mailing Address - Street 1:4035 EVERGREEN VILLAGE SQUARE
Mailing Address - Street 2:ST # 60
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95135
Mailing Address - Country:US
Mailing Address - Phone:669-333-9995
Mailing Address - Fax:408-693-3630
Practice Address - Street 1:4035 EVERGREEN VILLAGE SQUARE
Practice Address - Street 2:ST # 60
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95135
Practice Address - Country:US
Practice Address - Phone:669-333-9995
Practice Address - Fax:408-693-3630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA100673282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1770783292Medicare NSC