# OC PATH MEDICAL GROUP

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** ORANGE REGIONAL PATHOLOGY ASSOCIATE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235469685
- **Authorized official:** JON P LAKE MD (PRESIDENT)
- **Authorized official phone:** (714) 633-0011

## Contact information

- **Practice address:** 3350 W BALL RD, ANAHEIM, CA 92804-3710
- **Practice address phone:** (714) 827-6701
- **Mailing address:** PO BOX 10076, VAN NUYS, CA 91410-0076
- **Mailing address phone:** (805) 578-8300
- **Mailing address fax:** (805) 578-3911

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZC0500X | Cytopathology Physician | 05D0582538 | CA | — |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | 05D0582538 | CA | Yes |

## Other

- **Enumeration date:** 01/07/2010
- **Last updated:** 05/03/2010