Healthcare Provider Details

I. General information

NPI: 1073574075
Provider Name (Legal Business Name): PACIFIC RIM PATHOLOGY MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 08/03/2021
Certification Date: 08/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9295 FARNHAM ST STE 100
SAN DIEGO CA
92123-1254
US

IV. Provider business mailing address

FILE 1440
PASADENA CA
91199-1440
US

V. Phone/Fax

Practice location:
  • Phone: 858-939-3660
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES CARRY
Title or Position: PRESIDENT
Credential: MD
Phone: 619-522-3718