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Organization

C-S AND J PATHOLOGY MEDICAL GROUP, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MINDY ELLEN COOPER-SMITH M.D. (PRESIDENT)
(805) 652-1516
Entity
Organization

Contact information

Practice address
2170 SOUTH AVE, BARTON MEMORIAL HOSPITAL-PATHOLOGY, SOUTH LAKE TAHOE, CA 96150-7026
(530) 542-3000
(530) 543-0124
Mailing address
352 LINCOLN DR, VENTURA, CA 93001-2322
(805) 652-1516
(805) 652-2157

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2088350
NV
05
GR0016260
CA
Enumeration date
10/16/2005
Last updated
08/22/2020
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