Organization
ORAL PATHOLOGY ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND MELROSE D.D.S. (PRESIDENT)
(310) 235-1164
Entity
Organization
Contact information
Practice address
11500 W OLYMPIC BLVD, SUITE #390, LOS ANGELES, CA 90064-1524
(310) 235-1164
(310) 235-1067
Mailing address
11500 W OLYMPIC BLVD, SUITE #390, LOS ANGELES, CA 90064-1524
(310) 235-1164
(310) 235-1067
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CLF 11363
CA LAB ID NUMBER
CA
Enumeration date
02/21/2007
Last updated
08/22/2020
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