Organization
PHYSICIANS PATHOLOGY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS KASIMIAN MD (PRESIDENT)
(818) 780-3242
Entity
Organization
Contact information
Practice address
15211 VANOWEN ST, SUITE 303, VAN NUYS, CA 91405-3606
(818) 780-3242
(818) 780-3248
Mailing address
PO BOX 10076, VAN NUYS, CA 91410-0076
(805) 578-8300
(805) 578-8950
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ58862Z
BLUE SHIELD GROUP ID
CA
05
—
ZZZ58862Z
—
CA
Enumeration date
03/22/2006
Last updated
04/29/2008
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