Organization
ALTA EAST BAY PATHOLOGY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNETTE SHAIEB MD (PRESIDENT)
(510) 869-6567
Entity
Organization
Contact information
Practice address
3100 SUMMIT ST, OAKLAND, CA 94609-3410
(510) 869-6567
Mailing address
PO BOX 10076, VAN NUYS, CA 91410-0076
(805) 578-8300
(805) 578-8950
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0095400
—
CA
Enumeration date
05/16/2006
Last updated
03/07/2008
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