Organization
PROFESSIONAL PATHOLOGY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRVING FELDAKMP IV MD (PRESIDENT)
(562) 862-8282
Entity
Organization
Contact information
Practice address
3816 WOODRUFF AVE, LONG BEACH, CA 90808-2147
(562) 377-0389
(562) 425-7618
Mailing address
3816 WOODRUFF AVE, LONG BEACH, CA 90808-2147
(562) 377-0389
(562) 425-7618
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LAB68100G
MEDI-CAL
CA
Enumeration date
12/22/2006
Last updated
10/28/2008
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