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General NPI Number Information
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NPI Number | 1487876116
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Entity Type | Organization
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Legal Business Name | ALAMEDA COUNTY PUBLIC HEALTH LABORATORY
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 10/27/2016
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Provider Practice Location Address
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Address Line | 2901 PERALTA OAKS CT ROOM 206
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City | OAKLAND
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State | CA
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Zip | 94605-5319
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Country | US
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Telephone | 510-382-4300
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Fax | 510-382-4333
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Provider Business Mailing Address
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Address Line | 2901 PERALTA OAKS CT ROOM 206
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City | OAKLAND
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State | CA
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Zip | 94605-5319
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Country | US
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Telephone | 510-382-4300
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Fax | 510-382-4333
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Authorized Official
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Title or Position | DIRECTOR, LABORATORY SERVICES
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Name | DR. MARK WILLIAM PANDORI
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Credential | PHD
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Telephone | 510-382-4300
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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 | 05D0601931
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License Number State | CA
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Taxonomy #2
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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 | CA
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