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General NPI Number Information
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NPI Number | 1497705537
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Entity Type | Organization
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Legal Business Name | PATHOLOGY SCIENCES MEDICAL GROUP
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 04/16/2014
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Provider Practice Location Address
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Address Line | 183 E 8TH AVE
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City | CHICO
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State | CA
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Zip | 95926-2341
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Country | US
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Telephone | 530-891-6244
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Fax | 530-891-0134
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Provider Business Mailing Address
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Address Line | 183 E 8TH AVE
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City | CHICO
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State | CA
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Zip | 95926-2341
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Country | US
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Telephone | 530-891-6244
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Fax | 530-891-0134
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. LESTER K WONG
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Credential | M.D.
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Telephone | 530-891-6244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZC0500X
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Taxonomy Name | Cytopathology Physician
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License Number | CLF10112
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | CLF10112
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License Number State | CA
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