# DIAGNOSTIC PATHOLOGY MEDICAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023673167
- **Authorized official:** DR. DEREK K MARSEE MD (PRESIDENT)
- **Authorized official phone:** (916) 447-6267

## Contact information

- **Practice address:** 975 S FAIRMONT AVE, LODI, CA 95240-5118
- **Practice address phone:** (916) 447-6267
- **Practice address fax:** (916) 456-5842
- **Mailing address:** 3301 C ST STE 200E, SACRAMENTO, CA 95816-3363
- **Mailing address phone:** (916) 447-6267
- **Mailing address fax:** (916) 456-5842

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | Yes |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/03/2019
- **Last updated:** 05/03/2019