DIAGNOSTIC PATHOLOGY MEDICAL GROUP INC (NPI# 1023673167) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023673167 |
| Entity Type | Organization |
| Organization Name | DIAGNOSTIC PATHOLOGY MEDICAL GROUP INC |
| Practice Address |
975 S Fairmont Ave Lodi CA 95240-5118 |
| Mailing Address |
3301 C St Ste 200e Sacramento CA 95816-3363 |
| Practice Telephone | 9164476267 |
| Practice Fax Number | 9164565842 |
| Mailing Telephone | 9164476267 |
| Mailing Fax Number | 9164565842 |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2019-05-03 |
| Authorized Official Name | DR. DEREK K MARSEE (PRESIDENT) |
| Authorized Official Telephone | 9164476267 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669034518 | Diagnostic Pathology Medical Group Inc | Pathology | 2801 K St Ste 235, Sacramento, CA 95816-5170 | 2019-07-01 |
| 1235138868 | Diagnostic Pathology Medical Group Inc | Pathology | 3301 C St, #200e, Sacramento, CA 95816-3300 | 2005-07-15 |
| 1770064271 | Diagnostic Pathology Medical Group Inc | Pathology | 6490 S Mccarran Blvd, Bldge E Ste 106, Reno, NV 89509 | 2018-08-23 |
| 1992199160 | Diagnostic Pathology Medical Group Inc | Pathology | 300 Hospital Dr, Vallejo, CA 94589-2574 | 2015-03-25 |
| 1609948983 | Diagnostic Pathology Medical Group Inc | Specialist | 11815 Education St, Auburn, CA 95602-2410 | 2006-11-14 |
| 1184709313 | Diagnostic Pathology Medical Group Inc | Pathology | 2825 Capitol Ave, Sacramento, CA 95616-5616 | 2006-10-26 |
| 1386729549 | Diagnostic Pathology Medical Group Inc | Specialist | 4001 J St, Sacramento, CA 95819-3626 | 2006-10-26 |
| 1700961927 | Diagnostic Pathology Medical Group Inc | Specialist | 2000 Sutter Pl, Davis, CA 95616-6201 | 2006-10-26 |
| 1952486565 | Diagnostic Pathology Medical Group Inc | Specialist | 1 Medical Plaza Dr, Roseville, CA 95661-3037 | 2006-10-25 |
| 1588749162 | Diagnostic Pathology Medical Group Inc | Specialist | 5151 F St, Sacramento, CA 95819-3223 | 2006-10-25 |
| Street Address |
975 S FAIRMONT AVE |
| City | LODI |
| State | CA |
| Zip Code | 95240-5118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316938301 | Lodi Memorial Hospital Association Inc | General Acute Care Hospital | 975 S Fairmont Ave, Lodi, CA 95240-5118 | 2005-10-31 |
| 1174148662 | Minh Duc Phan | Pharmacist | 975 S Fairmont Ave, Lodi, CA 95240-5118 | 2020-06-10 |
| 1710500848 | Sara Ghohestani-bojd | Physician Assistant | 975 S Fairmont Ave, Lodi, CA 95240-5118 | 2020-05-23 |
| 1245864297 | Kristin Jean Gedda | Physician Assistant | 975 S Fairmont Ave, Lodi, CA 95240-5118 | 2020-02-28 |
| 1124663539 | Ryan Hortum | Occupational Therapist | 975 S Fairmont Ave, Lodi, CA 95240-5118 | 2019-11-08 |
| 1295390672 | Armeghan Bagherpour | Physician Assistant | 975 S Fairmont Ave, Lodi, CA 95240-5118 | 2019-05-01 |
| 1730643768 | Hannah Esther Keller | Physician Assistant | 975 S Fairmont Ave, Lodi, CA 95240-5118 | 2019-01-23 |
| 1699242065 | Elizabeth Emily Bennett | Registered Nurse | 975 S Fairmont Ave, Lodi, CA 95240-5118 | 2018-10-24 |
| 1669970778 | Jason Rogers | Physician Assistant | 975 S Fairmont Ave, Lodi, CA 95240-5118 | 2018-01-24 |
| 1346752946 | Manpreet Kaur Gill | Physician Assistant | 975 S Fairmont Ave, Lodi, CA 95240-5118 | 2017-11-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962034991 | Dr. Jeffrey A Saladin, Dental Corporation | Dentist | 1139 E. Kettleman Lane, Suite 101, Lodi, CA 95240 | 2020-02-07 |
| 1548747082 | Gill and Patel Dental Corporation | Dentist | 2610 Reynolds Ranch Pkwy, Ste 100, Lodi, CA 95240 | 2018-07-27 |
| 1629511308 | Jose Daniel Garcia | Licensed Vocational Nurse | 12755 Ca-88, Lodi, CA 95240 | 2016-11-29 |
| 1104372754 | Jocelyn Janel Shilue | Specialist/Technologist | 705 Brandywine Drive, Lodi, CA 95240 | 2016-09-01 |
| 1750735965 | Natharchia R Peoples | Counselor | 9150 Ca-12, Lodi, CA 95240 | 2016-04-14 |
| 1891189403 | Valley Community Couseling Services | Case Management | 1300 W. Lodi Ste G-2, Stockton, CA 95240 | 2015-03-20 |
| 1114317195 | Carol Kooyman | Speech-Language Pathologist | 831 So. Lee Ave., Lodi, CA 95240 | 2015-01-29 |
| 1730514464 | Richard Barry Sirard | Pharmacist | 520 S Cherokee Lane, Lodi, CA 95240 | 2013-09-12 |
| 1740622570 | Joshlynn Uribe | Marriage & Family Therapist | 13520 E Live Oak Rd, Lodi, CA 95240 | 2013-07-22 |
| 1902172406 | Sital Singh | Internal Medicine | 999 S Fairmont Ave Ste 125, Lodi, CA 95240 | 2012-03-29 |
| Find all providers in zip 95240 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063058170 | Paragon Diagnostics San Francisco | Pathology | 900 Hyde St Fl 1, San Francisco, CA 94109-4806 | 2019-11-24 |
| 1669034518 | Diagnostic Pathology Medical Group Inc | Pathology | 2801 K St Ste 235, Sacramento, CA 95816-5170 | 2019-07-01 |
| 1093277956 | Shajia Rahman Ansari | Pathology | 38558 Vancouver Cmn, Fremont, CA 94536-4056 | 2019-04-01 |
| 1831655158 | Rana Richeh | Pathology | 12 Spectrum Pointe Dr, Lake Forest, CA 92630-2242 | 2019-02-11 |
| 1710457510 | University of California Sfgh Medical Group | Pathology | 1001 Potrero Ave Rm 2m14, San Francisco, CA 94110-3518 | 2018-12-05 |
| 1770053233 | Samuel Jason Guzman | Pathology | 10026 Karmont Ave, South Gate, CA 90280-5417 | 2018-11-27 |
| 1144799750 | Penguin Medical Group, Inc | Pathology | 11 W Del Mar Blvd Ste 201, Pasadena, CA 91105-2593 | 2018-11-13 |
| 1023596731 | Uc San Diego, Pathology Dept | Pathology | East Campus Office Building, Medical Center Dr, San Diego, CA 92037 | 2018-08-03 |
| 1972080752 | Boris Shlopov Md Pathology Medical Corporation | Pathology | 800 S Main, Corona, CA 92882 | 2018-07-24 |
| 1902383920 | Ntr Resources, LLC | Pathology | 17433 Nordhoff, Northridge, CA 91325 | 2018-07-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.