Organization
PATHOLOGY & LABORATORY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT A ORLANDO MD (PRESIDENT)
(323) 725-4211
Entity
Organization
Contact information
Practice address
309 W BEVERLY BLVD, MONTEBELLO, CA 90640-4308
(323) 725-4211
(323) 889-2406
Mailing address
5856 CORPORATE AVE, SUITE 200, CYPRESS, CA 90630-4754
(714) 236-4000
(714) 236-4006
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0066850
—
CA
01
—
ZZZ02790Z
BLUE SHIELD
CA
Enumeration date
11/28/2006
Last updated
06/17/2015
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