Organization
LONG BEACH MEMORIAL PATHOLOGY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA SHANE MD (VICE PRES. TREASURER)
(562) 933-0713
Entity
Organization
Contact information
Practice address
2801 ATLANTIC AVE, DEPARTMENT OF PATHOLOGY, LONG BEACH, CA 90806-1701
(562) 933-0717
(562) 933-0791
Mailing address
2801 ATLANTIC AVE, DEPARTMENT OF PATHOLOGY, LONG BEACH, CA 90806-1701
(562) 933-0717
(562) 933-0791
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0049700
—
CA
01
—
ZZZ05043Z
BLUE SHIELD
CA
01
—
ZZZ96712Z
BLUE SHIELD
CA
Enumeration date
05/30/2006
Last updated
12/03/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us