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General NPI Number Information
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NPI Number | 1396842472
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Entity Type | Organization
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Legal Business Name | PATHOLOGY ARTS INC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 03/27/2024
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Provider Practice Location Address
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Address Line | 549 QUEENSLAND CIR STE 101
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City | CORONA
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State | CA
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Zip | 92879-1397
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Country | US
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Telephone | 951-270-0605
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Fax | 951-270-0675
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Provider Business Mailing Address
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Address Line | PO BOX 800247
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City | SANTA CLARITA
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State | CA
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Zip | 91380-0247
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Country | US
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Telephone | 661-705-3440
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Fax | 661-310-0478
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Authorized Official
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Title or Position | CEO
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Name | CURTIS LEE TAGUE
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Credential |
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Telephone | 951-270-0605
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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 | 05D1000595
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License Number State | CA
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