# C-S AND J PATHOLOGY MEDICAL GROUP, INC.

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

## Provider details

- **NPI number:** 1114916855
- **Authorized official:** DR. MINDY ELLEN COOPER-SMITH M.D. (PRESIDENT)
- **Authorized official phone:** (805) 652-1516

## Contact information

- **Practice address:** 2170 SOUTH AVE, BARTON MEMORIAL HOSPITAL-PATHOLOGY, SOUTH LAKE TAHOE, CA 96150-7026
- **Practice address phone:** (530) 542-3000
- **Practice address fax:** (530) 543-0124
- **Mailing address:** 352 LINCOLN DR, VENTURA, CA 93001-2322
- **Mailing address phone:** (805) 652-1516
- **Mailing address fax:** (805) 652-2157

## Taxonomy

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

## Other

- **Enumeration date:** 10/16/2005
- **Last updated:** 08/22/2020