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General NPI Number Information
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NPI Number | 1598098238
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Entity Type | Organization
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Legal Business Name | ALLIEDPATH
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Dates
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Enumeration Date | 09/14/2009
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Last Update Date | 09/14/2009
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Provider Practice Location Address
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Address Line | 10455 PACIFIC CENTER CT
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City | SAN DIEGO
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State | CA
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Zip | 92121-4339
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Country | US
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Telephone | 858-768-5361
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Fax |
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Provider Business Mailing Address
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Address Line | 3829 LUNA CT
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City | ALTADENA
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State | CA
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Zip | 91001-3865
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Country | US
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Telephone | 626-791-6202
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTORY
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Name | DR. JOHN E GLASSCO
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Credential | MD
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Telephone | 818-885-5398
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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 | A79154
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License Number State | CA
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