EXCELL E.N.T. MEDICAL GROUP, INC. (NPI# 1871532887) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871532887 |
| Entity Type | Organization |
| Organization Name | EXCELL E.N.T. MEDICAL GROUP, INC. |
| Practice Address |
645 W Harding Way Suite 6 Stockton CA 95204-5688 |
| Practice Telephone | 2099435185 |
| Practice Fax Number | 2099435187 |
| Mailing Telephone | 2099435185 |
| Mailing Fax Number | 2099435187 |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DEBRA K JOHNSON (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 2099435185 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD | ZZZ66439Z | 01 |
| Street Address |
645 W HARDING WAY SUITE 6 |
| City | STOCKTON |
| State | CA |
| Zip Code | 95204-5688 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427056209 | Yi-po Anthony Wu | Internal Medicine | 645 W Harding Way, Suite 15, Stockton, CA 95204-5688 | 2005-07-14 |
| 1144344136 | Austin Abbott Carpenter Jr. | Psychologist | 645 W Harding Way, Sutie 2, Stockton, CA 95204-5688 | 2007-03-17 |
| 1649356163 | Doo Kwang Lee | Emergency Medicine | 645 W Harding Way, Suite 5a, Stockton, CA 95204 | 2006-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962027524 | Kariem Abdelwahed | Licensed Vocational Nurse | 1630 N. Edison St Stockton Ca, Stockton, CA 95204 | 2020-06-10 |
| 1831730555 | Ronnie C Murray | Counselor | 1947 North California Street, Stockton, CA 95204 | 2019-10-03 |
| 1235614116 | Michelle Ann Horn | Marriage & Family Therapist | 3666 Mission Rd, Stockton, CA 95204 | 2018-09-26 |
| 1356830947 | Stockton Pace | PACE Provider Organization | 582 E. Harding Way, Stockton, CA 95204 | 2018-05-09 |
| 1790228781 | Rebecca Phongsa | Counselor | 1947 North Calfornia Street, Suite B, Stockton, CA 95204 | 2016-11-23 |
| 1700332905 | Serim Kang | Driver | 4222 N Pershing Ave, Suite D2, Stockton, CA 95204 | 2016-08-28 |
| 1033565544 | Philip John Brereton | Orthotist | 466 E Harding Way, Stockton, CA 95204 | 2016-05-13 |
| 1932507522 | David Grayson | Counselor | 1621 Brookside Rd, Stockton, CA 95204 | 2014-12-12 |
| 1174934897 | Gurtej Malhi | Internal Medicine | 1901 N California Street, Stockton, CA 95204 | 2014-05-15 |
| 1396156170 | Rajesh Saini | Nurse Practitioner | 1805 N California St. Suite 102, Stockton, CA 95204 | 2014-05-14 |
| Find all providers in zip 95204 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194764472 | Ronald George Dong | Otolaryngology | 10200 Trinity Pkwy Ste 201, Stockton, CA 95219-7288 | 2006-06-05 |
| 1972836104 | Kristin M Bennett Md Inc | Otolaryngology | 3132 W March Ln, 2, Stockton, CA 95219-2354 | 2009-09-04 |
| 1932288479 | Morris Allen Balfour | Otolaryngology | 10200 Trinity Pkwy, Stockton, CA 95219-7286 | 2006-11-03 |
| 1841377405 | Denise Valerie Guendert | Otolaryngology | 10200 Trinity Pkwy Ste 201, Stockton, CA 95219-7288 | 2006-11-01 |
| 1952488512 | Andrew Jungwook Limb | Otolaryngology | 10200 Trinity Pkwy Ste 201, Stockton, CA 95219-7288 | 2006-11-01 |
| 1467530378 | Donald G. Battaglia | Otolaryngology | 7373 West Ln, Stockton, CA 95210-3377 | 2006-11-01 |
| 1417035312 | Sanjay Marwaha | Otolaryngology | 7373 West Ln, Stockton, CA 95210-3377 | 2006-11-01 |
| 1407934227 | Brett L. Adams | Otolaryngology | 7373 West Ln, Stockton, CA 95210-3377 | 2006-11-01 |
| 1932201589 | Spencer L. Lowe | Otolaryngology | 10200 Trinity Pkwy Ste 201, Stockton, CA 95219-7288 | 2006-09-03 |
| 1285668707 | Susan R Cordes | Otolaryngology | 10200 Trinity Pkwy Ste 201, Stockton, CA 95219-7288 | 2006-07-10 |
| Find all providers in STOCKTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.