Organization
DIAGNOSTIC PATHOLOGY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEREK MARSEE (PRESIDENT)
(916) 446-0424
Entity
Organization
Contact information
Practice address
11815 EDUCATION ST, AUBURN, CA 95602-2410
(916) 447-6267
(916) 447-0621
Mailing address
3301 C ST, SUITE #200-E, SACRAMENTO, CA 95816-3300
(916) 447-6267
(916) 447-0621
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CS7233
MEDICARE RAILROAD
CA
05
—
GR0010577
—
CA
01
—
ZZZ39657Z
MEDICARE PTAN
CA
Enumeration date
11/14/2006
Last updated
09/27/2023
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