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General NPI Number Information
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NPI Number | 1053572776
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Entity Type | Individual
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Provider Name | SALLY ANN CROSS CLIN LAB SCIENTIST
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Gender | Female
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Dates
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Enumeration Date | 06/25/2008
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 8600 TUSCANY AVE #205
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City | PLAYA DEL REY
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State | CA
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Zip | 90293-8696
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Country | US
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Telephone | 310-578-9767
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Fax | 310-823-1404
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Provider Business Mailing Address
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Address Line | 8600 TUSCANY AVE #205
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City | PLAYA DEL REY
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State | CA
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Zip | 90293-8696
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Country | US
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Telephone | 310-578-9767
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Fax | 310-823-1404
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246QM0706X
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Taxonomy Name | Medical Technologist
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License Number | MTA28294
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 246QM0706X
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Taxonomy Name | Medical Technologist
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License Number | ASCP #134302
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 246QM0900X
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Taxonomy Name | Microbiology Specialist/Technologist
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License Number | ASCP #1587
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License Number State | CA
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