Healthcare Provider Details
I. General information
NPI: 1407825680
Provider Name (Legal Business Name): ANALYTIC PATHOLOGY MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/17/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5550 UNIVERSITY AVE
SAN DIEGO CA
92105-2307
US
IV. Provider business mailing address
PO BOX 10076
VAN NUYS CA
91410-0076
US
V. Phone/Fax
- Phone: 619-298-4485
- Fax:
- Phone: 805-578-8300
- Fax: 805-578-8950
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZC0500X |
| Taxonomy | Cytopathology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
B
CARRY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 619-298-4485