Organization
ST FRANCIS PATHOLOGY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD SCHNEIDER (OWNER)
(310) 900-8883
Entity
Organization
Contact information
Practice address
5856 CORPORATE AVE, SUITE 200, CYPRESS, CA 90630-4754
(714) 236-4000
(714) 236-4006
Mailing address
3630 E IMPERIAL HWY, DEPARTMENT OF PATHOLOGY, LYNWOOD, CA 90262-2609
(310) 900-8615
(310) 763-3907
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
G30735
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0067990
—
CA
01
—
ZZZ47547Z
BLUE SHIELD
CA
Enumeration date
09/20/2006
Last updated
10/05/2007
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