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General NPI Number Information
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NPI Number | 1669034518
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Entity Type | Organization
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Legal Business Name | DIAGNOSTIC PATHOLOGY MEDICAL GROUP INC
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Dates
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Enumeration Date | 07/01/2019
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Last Update Date | 07/01/2019
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Provider Practice Location Address
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Address Line | 2801 K ST STE 235
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City | SACRAMENTO
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State | CA
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Zip | 95816-5170
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Country | US
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Telephone | 916-447-6267
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Fax | 916-456-5842
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Provider Business Mailing Address
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Address Line | 3301 C ST STE 200E
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City | SACRAMENTO
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State | CA
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Zip | 95816-3363
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Country | US
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Telephone | 916-447-6267
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Fax | 916-456-5842
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DEREK K MARSEE
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Credential | M.D.
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Telephone | 916-447-6267
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State |
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