Organization
INTERSCOPE PATHOLOGY MEDICAL GROUP
Active
Organization
INTERSCOPE PATHOLOGY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN LIN MD (MEDICAL DIRECTOR)
(818) 992-7848
Entity
Organization
Contact information
Practice address
30700 RUSSELL RANCH RD SUITE 250, UNIT 235, WESTLAKE VILLAGE, CA 91362-5907
(818) 992-7848
(818) 992-7748
Mailing address
30700 RUSSELL RANCH RD STE 250, WESTLAKE VILLAGE, CA 91362-9507
(818) 992-7848
(818) 992-7943
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF3199
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0700248
MEDICARE/CLIA
CA
05
—
ZZZ59323Z
—
CA
Enumeration date
07/09/2008
Last updated
04/05/2026
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