Organization
EXCELLENCE HOME PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY JIMENEZ (OWNER)
(310) 276-7388
Entity
Organization
Contact information
Practice address
3150 LIVERNOIS RD STE 165, TROY, MI 48083-5061
(248) 996-8446
(248) 996-8261
Mailing address
3150 LIVERNOIS RD STE 165, TROY, MI 48083-5061
(248) 996-8446
(248) 996-8261
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
213EP1101X
Primary Podiatric Medicine Podiatrist
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
08/03/2017
Last updated
01/16/2023
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