Healthcare Provider Details

I. General information

NPI: 1417361411
Provider Name (Legal Business Name): CONTRA COSTA PATHOLOGY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2014
Last Update Date: 06/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2540 EAST ST
CONCORD CA
94520-1906
US

IV. Provider business mailing address

PO BOX 1440
SUISUN CITY CA
94585-4440
US

V. Phone/Fax

Practice location:
  • Phone: 925-270-3575
  • Fax: 925-270-3589
Mailing address:
  • Phone: 925-270-3575
  • Fax: 925-270-3589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BARRY P LATNER
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 925-270-3575