Organization
BAKERSFIELD PATHOLOGY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILIBETH GUINTO-MIRANDA MD (PRESIDENT)
(661) 336-0622
Entity
Organization
Contact information
Practice address
2828 H ST, SUITE D, BAKERSFIELD, CA 93301-1900
(661) 336-0622
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
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LAB98287F
GROUP ID
CA
01
—
ZZZ16224Z
BLUE SHIELD GROUP ID
CA
Enumeration date
03/17/2006
Last updated
08/22/2020
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