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Organization
LONG BEACH MEMORIAL PATHOLOGY MEDICAL GROUP, INC.
Active
Organization
LONG BEACH MEMORIAL PATHOLOGY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA SHANE MD (VICE PRES. TREASURER)
(562) 933-0713
Entity
Organization
Contact information
Practice address
2801 ATLANTIC AVE, DEPARTMENT OF PATHOLOGY, LONG BEACH, CA 90806-1701
(562) 933-0717
(562) 933-0791
Mailing address
2801 ATLANTIC AVE, DEPARTMENT OF PATHOLOGY, LONG BEACH, CA 90806-1701
(562) 933-0717
(562) 933-0791
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
NULL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
05/30/2006
Last updated
12/03/2014
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