# PEDIATRIC PATHOLOGY MEDICAL GROUP, INC

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

## Provider details

- **NPI number:** 1831256031
- **Authorized official:** STEPHEN H KASSEL M. D. (CEO)
- **Authorized official phone:** (559) 999-8583

## Contact information

- **Practice address:** 9300 VALLEY CHILDRENS PL, MADERA, CA 93638-8761
- **Practice address phone:** (559) 353-6103
- **Mailing address:** 3116 W MARCH LN, SUITE 200, STOCKTON, CA 95219-2369
- **Mailing address phone:** (209) 473-6555
- **Mailing address fax:** (209) 473-6543

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | G18364 | CA | Yes |

## Other

- **Enumeration date:** 01/03/2007
- **Last updated:** 08/22/2020