Healthcare Provider Details

I. General information

NPI: 1609945575
Provider Name (Legal Business Name): ORANGE COUNTY PATHOLOGY MEDICAL GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 10/06/2022
Certification Date: 04/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 W LA VETA AVE STE 104
ORANGE CA
92868-3928
US

IV. Provider business mailing address

805 W LA VETA AVE STE 104
ORANGE CA
92868-3928
US

V. Phone/Fax

Practice location:
  • Phone: 714-288-4044
  • Fax: 714-288-4042
Mailing address:
  • Phone: 714-288-4044
  • Fax: 714-288-4042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: AARON FRANKLIN SASSOON
Title or Position: PRESIDENT/PATHOLOGIST
Credential: PH.D., M.D.
Phone: 714-288-4044