Organization
CORONA PATHOLOGY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KAMAL ALI WAHEB (CEO)
(818) 402-8060
Entity
Organization
Contact information
Practice address
4444 W RIVERSIDE DR, SUITE 308, BURBANK, CA 91505-4073
(818) 566-1891
(818) 566-8834
Mailing address
4444 W RIVERSIDE DR, SUITE 308, BURBANK, CA 91505-4073
(818) 566-1891
(818) 566-8834
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
05D0879836
CA
291U00000X
Clinical Medical Laboratory
Primary
CLF00003712
CA
Other
Enumeration date
01/24/2007
Last updated
02/27/2012
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