MEMORIAL PATHOLOGY MEDICAL GROUP, INC. (NPI# 1417409269) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417409269 |
| Entity Type | Organization |
| Organization Name | MEMORIAL PATHOLOGY MEDICAL GROUP, INC. |
| Practice Address |
4081 E Olympic Blvd Los Angeles CA 90023-3330 |
| Mailing Address |
1633 Erringer Rd 1st Floor Simi Valley CA 93065-3583 |
| Practice Telephone | 3232670477 |
| 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 | 3232670477 |
| 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 |
|---|---|---|---|---|
| 1255883005 | Memorial Pathology Medical Group, Inc. | Pathology | 6245 De Longpre Ave, Hollywood, CA 90028-8253 | 2016-10-27 |
| 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 |
| Street Address |
4081 E OLYMPIC BLVD |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90023-3330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922001809 | Alta Los Angeles Hospitals, Inc. | Psychiatric Unit | 4081 E Olympic Blvd, Los Angeles, CA 90023-3330 | 2005-05-24 |
| 1306365903 | Jennifer Sik | Occupational Therapist | 4081 E Olympic Blvd, Los Angeles, CA 90023-3330 | 2017-09-14 |
| 1831617349 | Lynda Truc Nguyen | Nurse Practitioner | 4081 E Olympic Blvd, Los Angeles, CA 90023-3330 | 2017-09-05 |
| 1275907842 | Stephanie C. Cha, M.d. Inc. | Anesthesiology | 4081 E Olympic Blvd, Los Angeles, CA 90023-3330 | 2015-11-19 |
| 1982048039 | Patrick L Mullens M D Inc | Pathology | 4081 E Olympic Blvd, Los Angeles, CA 90023-3330 | 2013-04-19 |
| 1063765907 | Er Physicians Medical Group, Inc. | Emergency Medicine | 4081 E Olympic Blvd, Emergency Dept, Los Angeles, CA 90023-3330 | 2012-10-16 |
| 1962752675 | Friedrich Roessler, M.d., Inc. | Anesthesiology | 4081 E Olympic Blvd, Los Angeles, CA 90023-3330 | 2012-09-11 |
| 1306026562 | Shaival M Patel | Anesthesiology | 4081 E Olympic Blvd, Los Angeles, CA 90023-3330 | 2007-11-05 |
| 1114132685 | Alta Los Angeles Hospital, Inc | Skilled Nursing Facility | 4081 E Olympic Blvd, Los Angeles, CA 90023-3330 | 2007-05-10 |
| 1144381674 | Thomas Evans Mitchell Jr. | Anesthesiology | 4081 E Olympic Blvd, Los Angeles, CA 90023-3330 | 2006-12-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104470384 | Chan Family Medical Corp | General Practice | 4070 E. Olympic Blvd, Los Angeles, CA 90023 | 2019-07-26 |
| 1275059511 | Jeff Moreno | Psychoanalyst | 550 Vermount Ave, Los Angeles, CA 90023 | 2017-08-18 |
| 1457714297 | Isabel Garcia | Counselor | 4543 Sabina Street, Los Angeles, CA 90023 | 2016-03-30 |
| 1275950115 | Daniel Lemor | Ophthalmology | 4036 Whittier Blvd Ste 202, Los Angeles, CA 90023 | 2014-03-27 |
| 1073951992 | Behavioral Health Services, Inc. | Community/Behavioral Health | 2515 Whittier Blvd., Los Angeles, CA 90023 | 2013-06-13 |
| 1003115312 | H.r.imankhan,dds,inc | Dentist | 3356 E. Olympic Blvd, Los Angeles, CA 90023 | 2011-03-25 |
| 1508006297 | Ricca Tinnin | Physician Assistant | 1200 N State St., Dept E.r., La, CA 90023 | 2009-02-20 |
| 1538366851 | Sun Heung Lui | Counselor | 3421 E. Olympic Blvd., Los Angeles, CA 90023 | 2007-06-29 |
| 1851519623 | Atlantic Recovery Services | Community/Behavioral Health | 3225 Flunter St, Estrada Courts Sea, Los Angeles, CA 90023 | 2007-04-24 |
| 1548486947 | Manasseh C Nwaigwe | General Practice | 1159 S. Lorena St, Los Angeles, CA 90023 | 2007-04-17 |
| Find all providers in zip 90023 | ||||
| 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 |
|---|---|---|---|---|
| 1023512126 | Sofia Liou | Pathology | 924 Westwood Blvd Ste 705, Los Angeles, CA 90024-2959 | 2018-03-22 |
| 1134645732 | Jennifer Katzenberg | Pathology | 10833 Le Conte Ave # Chsas, Los Angeles, CA 90095-3075 | 2017-08-16 |
| 1144678426 | Jayjay Zabala Blanco | Pathology | 116 N Robertson Blvd Ste 500, Los Angeles, CA 90048-3100 | 2016-05-27 |
| 1962866855 | Sai Priyanka Gudiwada | Pathology | 10833 Le Conte Ave # A2-179, Los Angeles, CA 90095-1202 | 2016-04-07 |
| 1003229329 | Tiannan Wang | Pathology | 1500 San Pablo St Rm 216, Los Angeles, CA 90033-5313 | 2014-06-04 |
| 1356754840 | Ahmad Ibrahim | Pathology | 1450 San Pablo St Rm 2401, Los Angeles, CA 90033-5331 | 2014-06-03 |
| 1396015434 | Lily Jih | Pathology | 8700 Beverly Blvd., #8709, South Tower, Los Angeles, CA 90048 | 2012-01-06 |
| 1588993059 | Jennifer Lynne Clebanoff | Pathology | Ucla Pathology and Laboratory Medicine, Box 951732, A7-149 Chs, Los Angeles, CA 90095-1732 | 2009-12-13 |
| 1326277385 | Saloni Walia | Pathology | 2011 Zonal Ave # Hmr211, Los Angeles, CA 90089-1083 | 2009-07-10 |
| 1336377829 | Matthew Denicola | Pathology | 10833 Le Conte Ave Box 951732, Los Angeles, CA 90095-1732 | 2009-06-23 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90023 |
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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.