Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Axoderm Corp

Organization Medical Toxicology (Emergency Medicine) Physician · NPI 1891675674

Axoderm Corp is a Medical Toxicology (Emergency Medicine) Physician in Glendale, California. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1510 S Central Ave Ste 640
Glendale, CA 91204-2552
Phone: (310) 933-5054
Fax: (310) 935-3367
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Specialties & licences

Medical Toxicology (Emergency Medicine) Physician (primary) Taxonomy 207PT0002X

Record details

NPI number1891675674
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Angie Davoody — Office Manager / Executive · (818) 242-3200
NPI enumeratedSeptember 3, 2025
Last updated in NPPESSeptember 3, 2025
Certification dateSeptember 3, 2025
Mailing address1510 S Central Ave Ste 640, Glendale, CA 91204-2552

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