Organization
EXCEL HEALTHCARE, INC.
Active
Other names
West Covina Adult Day Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
HAROLD G FAJARDO M.D. (ADMINISTRATOR)
(626) 918-9887
Entity
Organization
Contact information
Practice address
1633 N HACIENDA BLVD, LA PUENTE, CA 91744-1137
(626) 918-9887
(626) 918-6647
Mailing address
1633 N HACIENDA BLVD, LA PUENTE, CA 91744-1137
(626) 918-9887
(626) 918-6647
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
060000795
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ADU70285F
—
CA
01
—
CMCSUBHVY
CMC SUBMISSION ID
CA
Enumeration date
04/26/2007
Last updated
09/29/2008
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