# PENINSULA PATHOLOGISTS MEDICAL GROUP INC.

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

## Provider details

- **NPI number:** 1285699793
- **Authorized official:** DR. JUDY A ALONZO M.D. (PRESIDENT)
- **Authorized official phone:** (650) 616-2950

## Contact information

- **Practice address:** 1783 EL CAMINO REAL, PATHOLOGY DEPT, BURLINGAME, CA 94010-3205
- **Practice address phone:** (650) 696-5611
- **Mailing address:** 383 E GRAND AVE, SUITE A, SOUTH SAN FRANCISCO, CA 94080-6234
- **Mailing address phone:** (650) 616-2951

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207U00000X | Nuclear Medicine Physician | CLF331997 | CA | — |
| 207ZC0500X | Cytopathology Physician | CLF331997 | CA | — |
| 207ZD0900X | Dermatopathology (Pathology) Physician | CLF331997 | CA | — |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | Yes |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/18/2006
- **Last updated:** 10/16/2007