Oc Path Medical Group Orange Regional Pathology Associate
Pathology, Anatomic Pathology & Clinical Pathology in Garden Grove, CA. Organization (NPI-2).
NPI number1750488987
StatusActive
Last updated in NPPESJul 29, 2008
Details
- NPI
- 1750488987
- Entity type
- Organization (NPI-2)
- Legal business name
- Oc Path Medical Group Orange Regional Pathology Associate
- Organization subpart
- No
- Enumeration date
- Sep 20, 2006
- Last updated
- Jul 29, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207ZP0102X | Pathology, Anatomic Pathology & Clinical Pathology | – | – | Yes |
| 207ZC0500X | Pathology, Cytopathology | – | – |
Practice location
12601 Garden Grove BlvdGarden Grove, CA 92843-1908
Phone 714-741-2765
Mailing address
Po Box 10076Van Nuys, CA 91410-0076
Phone 805-578-8300 · Fax 805-578-8950
Authorized official
Jon P Lake
President
7147412765
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