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General NPI Number Information
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NPI Number | 1184207730
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Entity Type | Organization
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Legal Business Name | MALIBU PATHOLOGY
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Dates
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Enumeration Date | 05/02/2021
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 28222 AGOURA RD STE 101
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City | AGOURA HILLS
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State | CA
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Zip | 91301-2484
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Country | US
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Telephone | 310-497-1335
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Fax |
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Provider Business Mailing Address
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Address Line | 28222 AGOURA RD STE 101
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City | AGOURA HILLS
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State | CA
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Zip | 91301-2484
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Country | US
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Telephone | 310-497-1335
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Fax |
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Authorized Official
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Title or Position | MEDICAL LAB DIRECTOR
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Name | MAN LI
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Credential | PHD
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Telephone | 310-497-1335
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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 |
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License Number State |
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