Healthcare Provider Details
I. General information
NPI: 1811081797
Provider Name (Legal Business Name): VALLEY PATHOLOGY MEDICAL ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/03/2006
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2185 CITRACADO PKWY
ESCONDIDO CA
92029-4159
US
IV. Provider business mailing address
5700 SOUTHWYCK BLVD
TOLEDO OH
43614-1509
US
V. Phone/Fax
- Phone: 442-281-5000
- Fax: 419-866-5453
- Phone: 800-288-8325
- Fax: 419-866-5453
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZB0001X |
| Taxonomy | Blood Banking & Transfusion Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZC0500X |
| Taxonomy | Cytopathology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JERRY
KOLINS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 760-739-3039