Organization
BAYLESS PATHMARK INC
Active
Parent organization
BAYLESS PATHMARK INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BAYLESS PATHMARK INC
Authorized official
DR. YILAN CHANG (PRESIDENT)
(440) 826-0384
Entity
Organization
Contact information
Practice address
SOUTHWEST GENERAL HEALTH CENTER, 18697 BAGLEY ROAD, LABORATORY SERVICES, CLEVELAND, OH 44130
(440) 826-0384
(440) 826-1910
Mailing address
19250 BAGLEY RD STE 101, MIDDLEBURG HEIGHTS, OH 44130-3348
(440) 826-0384
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0119535
—
OH
01
—
=========
BWC
OH
Enumeration date
10/19/2007
Last updated
02/21/2020
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