Organization
ASSOCIATED PATHOLOGY MEDICAL GROUP, INC
Active
Parent organization
ASSOCIATED PATHOLOGY MEDICAL GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
ASSOCIATED PATHOLOGY MEDICAL GROUP
Authorized official
ELIZABETH ANN SANDOVAL (BILLING MANAGER)
(408) 884-2710
Entity
Organization
Contact information
Practice address
1555 SOQUEL DR, SANTA CRUZ, CA 95065-1705
(408) 884-2710
(408) 884-2734
Mailing address
PO BOX 665, LOS GATOS, CA 95031-0665
(408) 884-2710
(408) 884-2734
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
05D0606603
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CS1327
MEDICARE RAILROAD
CA
05
—
GR0088851
—
CA
01
—
Q682
SAN FRANCISCO HEALTH PLAN
CA
Enumeration date
10/27/2006
Last updated
06/24/2020
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