Organization
IRVINE PATHOLOGY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN M RUSHOVICH M.D. (PRESIDENT)
(949) 387-8111
Entity
Organization
Contact information
Practice address
15375 BARRANCA PKWY, STE H-105, IRVINE, CA 92618-2209
(949) 387-8111
(949) 387-6163
Mailing address
15375 BARRANCA PKWY, STE H-105, IRVINE, CA 92618-2209
(949) 387-8111
(949) 387-6163
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
FNP19555
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0057490
—
CA
Enumeration date
09/25/2006
Last updated
07/30/2019
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