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General NPI Number Information
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NPI Number | 1023596731
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Entity Type | Organization
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Legal Business Name | UC SAN DIEGO, PATHOLOGY DEPT
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Dates
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Enumeration Date | 08/03/2018
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Last Update Date | 08/03/2018
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Provider Practice Location Address
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Address Line | EAST CAMPUS OFFICE BUILDING MEDICAL CENTER DR
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City | SAN DIEGO
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State | CA
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Zip | 92037
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Country | US
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Telephone | 858-657-6772
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Fax |
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Provider Business Mailing Address
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Address Line | 7565 CHARMANT DR UNIT 412
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City | SAN DIEGO
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State | CA
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Zip | 92122-5003
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Country | US
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Telephone | 415-624-7424
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Fax |
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Authorized Official
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Title or Position | RESIDENT
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Name | JEENAL GORDHANDAS
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Credential |
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Telephone | 415-624-7424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State |
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