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General NPI Number Information
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NPI Number | 1144357948
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Entity Type | Organization
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Legal Business Name | SAN DIEGO COUNTY PUBLIC HEALTH LABORATORY
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 05/26/2009
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Provider Practice Location Address
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Address Line | 3851 ROSECRANS ST SUITE 716
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City | SAN DIEGO
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State | CA
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Zip | 92110-3115
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Country | US
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Telephone | 619-692-8500
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Fax | 619-692-8558
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Provider Business Mailing Address
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Address Line | 3851 ROSECRANS ST MS P572
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City | SAN DIEGO
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State | CA
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Zip | 92110-3115
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Country | US
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Telephone | 619-692-8500
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Fax | 619-692-8558
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Authorized Official
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Title or Position | LABORATORY DIRECTOR
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Name | DR. PATRICIA A MCVAY
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Credential | M.D.
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Telephone | 619-692-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 05D0060808
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License Number State | CA
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