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General NPI Number Information
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NPI Number | 1659691087
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Entity Type | Organization
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Legal Business Name | PRECISION PATHOLOGY MEDICAL GROUP INC
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Dates
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Enumeration Date | 06/08/2010
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Last Update Date | 06/08/2010
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Provider Practice Location Address
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Address Line | 27200 CALAROGA AVE
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City | HAYWARD
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State | CA
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Zip | 94545-4339
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Country | US
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Telephone | 510-264-4035
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Fax | 510-786-3492
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Provider Business Mailing Address
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Address Line | PO BOX 10076
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City | VAN NUYS
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State | CA
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Zip | 91410-0076
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Country | US
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Telephone | 805-578-8300
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Fax | 805-578-3911
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Authorized Official
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Title or Position | PRESIDENT
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Name | CARL H CRITZ
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Credential | MD
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Telephone | 510-264-4035
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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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