Organization · NPI-2

Children'S Specialists Of San Diego - Div Of Path

Pathology, Anatomic Pathology & Clinical Pathology · San Diego, CA

NPI number1497812960

StatusActive

Last updated in NPPESApr 22, 2008

Details

NPI: 1497812960
Entity type: Organization (NPI-2)
Legal business name: Children'S Specialists Of San Diego - Div Of Path
Organization subpart: Yes
Enumeration date: Jan 3, 2007
Last updated: Apr 22, 2008

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207ZP0102X	Pathology, Anatomic Pathology & Clinical Pathology	–	–	Yes
207ZP0101X	Pathology, Anatomic Pathology	–	–
207ZP0213X	Pathology, Pediatric Pathology	–	–

Other names

Children'S Associated Medical Group (Former Legal Business Name)

Practice location

3020 Childrens Way
San Diego, CA 92123-4223

Phone 858-966-5944

Mailing address

3860 Calle Fortunada
Suite 210
San Diego, CA 92123-4800

Phone 858-309-6303 · Fax 858-309-6301

Authorized official

Herbert C. Kimmons
Credentialing
8589668567

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