Pacific Pathology Medical Group Inc

LBN: Pacific Pathology Medical Group Inc
Pacific Pathology Medical Group Inc is an health care organization with primary practice located at 555 E Hardy St Pathology Department, Inglewood CA 90301. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology, which is considered as the primary health care specialty. Pacific Pathology Medical Group Inc can be contacted via phone (310) 680-8391, or through Worthen, Willard Frank via phone (310) 680-8391.

Contact Information

Primary practice address
555 E Hardy St Pathology Department Inglewood CA 90301
Fax: (310) 412-4501
Website:
Authorized official contact:
Name: Worthen, Willard Frank Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology 207ZP0101X

Profile Details

NPI number 1609953736
LBN Legal business name Pacific Pathology Medical Group Inc
DBA Doing business as
Authorized official Worthen, Willard Frank Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 1st, 2006
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609953736 NPPES
California MEDICAID GR0045861
California MEDICAID GR0045860

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