Organization
EL CAMINO PATHOLOGY MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES M LOMBARD M.D. (PRESIDENT)
(650) 940-7233
Entity
Organization
Contact information
Practice address
2500 GRANT RD, ELCAMINO PATHOLOGY DEPT, MOUNTAIN VIEW, CA 94040-4302
(650) 940-7233
Mailing address
PO BOX 281440, SAN FRANCISCO, CA 94128-1440
(650) 616-2948
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
CLF445
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CLF445
LAB LICENSE
CA
05
—
GR0052880
—
CA
Enumeration date
11/01/2006
Last updated
11/02/2017
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