Healthcare Provider Details

I. General information

NPI: 1235138868
Provider Name (Legal Business Name): DIAGNOSTIC PATHOLOGY MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 C ST #200E
SACRAMENTO CA
95816-3300
US

IV. Provider business mailing address

3301 C ST #200E
SACRAMENTO CA
95816-3300
US

V. Phone/Fax

Practice location:
  • Phone: 916-447-6267
  • Fax: 916-447-0621
Mailing address:
  • Phone: 916-447-6267
  • Fax: 916-447-0621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207ZN0500X
TaxonomyNeuropathology Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code207ZP0007X
TaxonomyMolecular Genetic Pathology (Pathology) Physician
License Number
License Number StateNULL
# 5
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number05D0644168
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code207ZC0006X
TaxonomyClinical Pathology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. MICHAEL J FINN
Title or Position: C.E.O.
Credential:
Phone: 916-447-6267