Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Axoderm Corp

Organization Medical Toxicology (Emergency Medicine) Physician · NPI 1891675674

Axoderm Corp provides Medical Toxicology (Emergency Medicine) Physician services 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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