Organization
PACIFIC RIM PATHOLOGY MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES CARRY MD (MEDICAL DIRECTOR)
(858) 939-3660
Entity
Organization
Contact information
Practice address
3030 BUNKER HILL STREET, SUITE 201, SAN DIEGO, CA 92109
(858) 638-8120
Mailing address
4980 CARROLL CANYON RD, SUITE 2, SAN DIEGO, CA 92121-1736
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
207ZP0102X
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D2058823
MEDICARE ID
CA
05
—
GR0080124
—
CA
Enumeration date
11/27/2013
Last updated
08/03/2021
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