| NPI | 1568702017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY ANTONIO Bookkeeper 805-710-7308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: CA 05D0921025) |
| Additional Taxonomies | 207ZC0500X Pathology Cytopathology |
| Enumeration Date | 2013-02-20 |
| Last Update Date | 2024-06-20 |