Individual provider · NPI-1
Mohamed A Elbaz, MS MB(ASCP)
Spec/Tech, Pathology, Laboratory Management · Templeton, CA
NPI number1295079242
StatusActive
Last updated in NPPESJan 14, 2021
Details
- NPI
- 1295079242
- Entity type
- Individual (NPI-1)
- Name
- Mr. Mohamed A Elbaz
- Credential
- MS MB(ASCP)
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 15, 2012
- Certification date
- Jan 14, 2021
- Last updated
- Jan 14, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 246QL0900X | Spec/Tech, Pathology, Laboratory Management | – | TX | Yes |
| 246QM0706X | Spec/Tech, Pathology, Medical Technologist | 1825 | OR | |
| 246ZB0500X | Specialist/Technologist, Other, Biochemist | – | – |
Practice location
1050 Las Tablas Rd Ste 14Templeton, CA 93465-9480
Phone 503-464-6467
Mailing address
5351 S VincentMesa, AZ 85212-9113
Phone 503-464-6467
Other practice locations
13705 Ne Airport Way
Portland, OR 97230-1048
Portland, OR 97230-1048
Phone 503-464-6467
5130 Gateway Blvd E
El Paso, TX 79905-1608
El Paso, TX 79905-1608
Phone 503-464-6467
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.