Organization
MEMORIAL PATHOLOGY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM POWER MD (LABORATORY DIRECTOR)
(310) 836-7000
Entity
Organization
Contact information
Practice address
3828 DELMAS TER, CULVER CITY, CA 90232-2713
(310) 836-7000
(310) 815-3107
Mailing address
PO BOX 10076, VAN NUYS, CA 91410-0076
(805) 578-8300
(805) 578-8950
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0016480
—
CA
Enumeration date
04/04/2006
Last updated
01/17/2013
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