# EXCELLENCE HOME PHYSICIANS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609391382
- **Authorized official:** GEOFFREY JIMENEZ (OWNER)
- **Authorized official phone:** (310) 276-7388

## Contact information

- **Practice address:** 3150 LIVERNOIS RD STE 165, TROY, MI 48083-5061
- **Practice address phone:** (248) 996-8446
- **Practice address fax:** (248) 996-8261
- **Mailing address:** 3150 LIVERNOIS RD STE 165, TROY, MI 48083-5061
- **Mailing address phone:** (248) 996-8446
- **Mailing address fax:** (248) 996-8261

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 213EP1101X | Primary Podiatric Medicine Podiatrist | — | NULL | — |
| 213EP1101X | Primary Podiatric Medicine Podiatrist | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 08/03/2017
- **Last updated:** 01/16/2023