Organization
LAGUNA PATHOLOGY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER VANLEY M.D. (PRESIDENT)
(949) 499-7181
Entity
Organization
Contact information
Practice address
31872 COAST HWY, LAGUNA BEACH, CA 92651-6773
(949) 499-7181
Mailing address
PO BOX 7630, LAGUNA NIGUEL, CA 92607-7630
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0047360
—
CA
01
—
ZZZ29149Z
BLUE CROSS
—
Enumeration date
09/17/2006
Last updated
12/20/2007
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