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General NPI Number Information
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NPI Number | 1912930900
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Entity Type | Organization
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Legal Business Name | THOUSAND OAKS PATHOLOGY ASSOCIATES INC
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 351 ROLLING OAKS DR SUITE 100
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City | THOUSAND OAKS
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State | CA
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Zip | 91361-1275
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Country | US
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Telephone | 805-373-8582
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Fax | 805-373-0023
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Provider Business Mailing Address
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Address Line | PO BOX 39215
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City | LOS ANGELES
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State | CA
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Zip | 90039-2165
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Country | US
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Telephone | 800-288-8325
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Fax | 419-866-5453
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Authorized Official
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Title or Position | PATHOLOGIST/MANAGING PARTNER
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Name | DR. WAYNE MERRITT SCHULTHEIS
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Credential | M.D.
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Telephone | 805-373-8582
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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 | 05D1022855
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License Number State | CA
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