Provider Demographics
NPI:1962910513
Name:EXCEL IMAGING CENTER INC
Entity type:Organization
Organization Name:EXCEL IMAGING CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:KHANH
Authorized Official - Middle Name:
Authorized Official - Last Name:DUONG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:714-583-8147
Mailing Address - Street 1:13071 BROOKHURST ST STE 100
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-5514
Mailing Address - Country:US
Mailing Address - Phone:714-583-8126
Mailing Address - Fax:714-583-8148
Practice Address - Street 1:13071 BROOKHURST ST STE 100
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-5514
Practice Address - Country:US
Practice Address - Phone:714-583-8126
Practice Address - Fax:714-583-8148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-17
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Multi-Specialty