MEMORIAL PATHOLOGY MEDICAL GROUP, INC. (NPI# 1255883005) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255883005 |
| Entity Type | Organization |
| Organization Name | MEMORIAL PATHOLOGY MEDICAL GROUP, INC. |
| Practice Address |
6245 De Longpre Ave Hollywood CA 90028-8253 |
| Mailing Address |
1633 Erringer Rd 1st Floor Simi Valley CA 93065-3583 |
| Practice Telephone | 3234622271 |
| Mailing Telephone | 8055788300 |
| Mailing Fax Number | 8055783911 |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2016-11-09 |
| Authorized Official Name | DR. WILLIAM POWER (PRESIDENT) |
| Authorized Official Telephone | 3234622271 |
| Authorized Official Credential | M.D. |
| 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 |
|---|---|---|---|---|
| 1134671985 | Memorial Pathology Medical Group, Inc. | Clinical Medical Laboratory | 14433 Emelita St, Van Nuys, CA 91401-4213 | 2016-10-27 |
| 1588116321 | Memorial Pathology Medical Group, Inc. | Pathology | 13222 Bloomfield Ave, Norwalk, CA 90650-3249 | 2016-10-27 |
| 1679025423 | Memorial Pathology Medical Group, Inc. | Clinical Medical Laboratory | 9542 Artesia Blvd, Bellflower, CA 90706-6511 | 2016-10-27 |
| 1417409269 | Memorial Pathology Medical Group, Inc. | Pathology | 4081 E Olympic Blvd, Los Angeles, CA 90023-3330 | 2016-10-27 |
| Street Address |
6245 DE LONGPRE AVE |
| City | HOLLYWOOD |
| State | CA |
| Zip Code | 90028-8253 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023010113 | Southern California Healthcare System, Inc | General Acute Care Hospital | 6245 De Longpre Ave, Hollywood, CA 90028-8253 | 2005-06-02 |
| 1730631730 | Arnel M Joaquin M D Inc | Specialist | 6245 De Longpre Ave, Suite 206, B, Hollywood, CA 90028-8253 | 2016-10-26 |
| 1881898740 | Joel Frederick Fine, Md A Med | Anesthesiology | 6245 De Longpre Ave, Hollywood, CA 90028-8253 | 2007-06-13 |
| 1346340494 | Cornelio C. Manzano Jr. | Specialist | 6245 De Longpre Ave, 206, Hollywood, CA 90028-8253 | 2006-09-25 |
| 1265470868 | Ideal Health Care and Medical | Specialist | 6245 De Longpre Ave, 206, Hollywood, CA 90028-8253 | 2006-06-04 |
| 1699713966 | Alexis Nixon | Physician Assistant | 6245 De Longpre Ave, 206, Hollywood, CA 90028-8253 | 2006-06-02 |
| 1730141888 | Patrick L Mullens | Pathology | 6245 De Longpre Ave, Hollywood, CA 90028-8253 | 2006-04-04 |
| 1144281163 | Kenneth C Nieberg Md Inc | Pathology | 6245 De Longpre Ave, Hollywood, CA 90028-8253 | 2006-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154929859 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 5500 W Sunset Blvd, Los Angeles, CA 90028 | 2020-10-14 |
| 1558993527 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 5500 West Sunset Boulevard, Los Angeles, CA 90028 | 2020-02-07 |
| 1639715030 | Michelle Jennifer Martinez | Case Manager/Care Coordinator | 6838 Sunset Blvd., Hollywood, CA 90028 | 2019-11-20 |
| 1821562315 | Ronnie Jerome Jackson | Case Manager/Care Coordinator | Bhs Hollywood Recovery Center, 6838 Sunset Blvd, Hollywood, CA 90028 | 2019-01-17 |
| 1669961595 | Danielle Arce | Dietitian, Registered | 6721 De Longpre Ave, Los Angeles, CA 90028 | 2018-05-07 |
| 1982124772 | Yoon Kyung Lee | Pharmacist | 7201 Hollywood Blvd, Los Angeles, CA 90028 | 2017-06-22 |
| 1982133245 | Julia West | Pharmacist | 6201 Hollywood Blvd #126, Los Angeles, CA 90028 | 2017-06-08 |
| 1720527971 | Melissa Susac | Marriage & Family Therapist | 1540 Schrader Blvd, Garden Suite 12, Hollywood, CA 90028 | 2017-02-21 |
| 1023554284 | Arlene Aranda | Social Worker | 1873 Taft Ave, Los Angeles, CA 90028 | 2017-01-12 |
| 1912304775 | Damon Dodge | Marriage & Family Therapist | 7083 Hollywood Blvd, Los Angeles, CA 90028 | 2014-11-21 |
| Find all providers in zip 90028 | ||||
| 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 |
|---|---|---|---|---|
| 1881038768 | Patrick L Mullens M D Inc | Pathology | 6245 Delongpre Avenue, Hollywood, CA 90028-8253 | 2013-04-23 |
| 1396198156 | Elena Ladich | Pathology | 3501 Johnson St, Room 2-281m, Hollywood, FL 33021-5421 | 2016-07-18 |
| 1720249329 | Artur Eduardo De Oliveira Rangel Filho | Pathology | 3501 Johnson St, Room 2-281m, Hollywood, FL 33021-5421 | 2008-06-17 |
| 1780859918 | Tania Zuluaga Toro | Pathology | 3501 Johnson St, Room 2-281m, Hollywood, FL 33021-5421 | 2008-04-29 |
| 1497873822 | Sandra E. Barnick | Pathology | 3501 Johnson St, Hollywood, FL 33021-5421 | 2007-03-26 |
| 1396818563 | Lisa Nichol Tyler | Pathology | 3501 Johnson St, Hollywood, FL 33021-5421 | 2006-11-16 |
| 1538179718 | Kourosh Pakzad | Pathology | 3501 Johnson St, Hollywood, FL 33021-5421 | 2006-08-09 |
| 1962416818 | Frederick Leonard Kiechle | Pathology | 3501 Johnson St, Hollywood, FL 33021-5421 | 2006-07-28 |
| 1598720138 | Neil A Abrahams | Pathology | 3501 Johnson St, Hollywood, FL 33021-5421 | 2006-04-18 |
| 1003894767 | Mohammad Ali Lari | Pathology | 3501 Johnson St, Hollywood, FL 33021-5421 | 2006-01-04 |
| Find all providers in HOLLYWOOD | ||||
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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.