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General NPI Number Information
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NPI Number | 1952325565
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Entity Type | Organization
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Legal Business Name | UNIVERSITY PATHOLOGY ASSOCIATES, INC.
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 07/24/2008
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Provider Practice Location Address
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Address Line | 2011 ZONAL AVE, SUITE 209
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City | LOS ANGELES
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State | CA
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Zip | 90089-0181
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Country | US
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Telephone | 323-442-2582
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Fax | 323-442-2588
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Provider Business Mailing Address
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Address Line | 2011 ZONAL AVE SUITE 209
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City | LOS ANGELES
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State | CA
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Zip | 90089-5364
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Country | US
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Telephone | 323-442-2582
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Fax | 323-442-2588
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CLIVE R. TAYLOR
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Credential | M.D., PH.D.
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Telephone | 323-442-1180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZB0001X
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Taxonomy Name | Blood Banking & Transfusion Medicine Physician
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License Number | 05D0928654
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207ZC0500X
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Taxonomy Name | Cytopathology Physician
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License Number | 05D0928654
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207ZD0900X
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Taxonomy Name | Dermatopathology (Pathology) Physician
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License Number | 05D0928654
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207ZF0201X
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Taxonomy Name | Forensic Pathology Physician
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License Number | 05D0928654
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 207ZH0000X
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Taxonomy Name | Hematology (Pathology) Physician
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License Number | 05D0928654
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 207ZI0100X
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Taxonomy Name | Immunopathology Physician
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License Number | 05D0928654
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License Number State | CA
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Taxonomy #7
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Taxonomy Code | 207ZM0300X
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Taxonomy Name | Medical Microbiology Physician
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License Number | 05D0928654
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License Number State | CA
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Taxonomy #8
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Taxonomy Code | 207ZN0500X
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Taxonomy Name | Neuropathology Physician
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License Number | 05D0928654
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License Number State | CA
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Taxonomy #9
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Taxonomy Code | 207ZP0007X
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Taxonomy Name | Molecular Genetic Pathology (Pathology) Physician
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License Number | 05D0928654
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License Number State | CA
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Taxonomy #10
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | 05D0928654
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License Number State | CA
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Taxonomy #11
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Taxonomy Code | 207ZP0104X
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Taxonomy Name | Chemical Pathology Physician
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License Number | 05D0928654
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License Number State | CA
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Taxonomy #12
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number | 05D0928654
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License Number State | CA
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Taxonomy #13
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Taxonomy Code | 207ZP0213X
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Taxonomy Name | Pediatric Pathology Physician
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License Number | 05D0928654
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License Number State | CA
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Taxonomy #14
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 05D0928654
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License Number State | CA
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