Organization
MAMMOTH PATH SOLUTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN HILTON (OWNER)
(305) 332-0669
Entity
Organization
Contact information
Practice address
20505 CRESCENT BAY DR STE A2, LAKE FOREST, CA 92630-8825
(949) 317-0345
(949) 446-9141
Mailing address
20505 CRESCENT BAY DR, LAKE FOREST, CA 92630-8825
(949) 317-0345
(949) 446-9141
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
11/21/2023
Last updated
01/23/2024
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