NPIMap

Organization Active NPI

Pacific Breast Pathology Medical Corporation

  • Clinical Medical Laboratory
  • Novato, CA
National Provider Identifier
1023396348
Registry record updated Aug 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
PACIFIC BREAST PATHOLOGY MEDICAL CORPORATION
Practice address
101 Calypso SHRS
Novato, CA 94949-5344
Phone
(650) 238-4033
NPI assigned
Aug 3, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Philip Dutt, MDNPI 1649203167
Title
Vice President
Phone
(650) 238-4033

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

101 Calypso SHRS
Novato, CA 94949-5344

Mailing address

101 Calypso SHRS
Novato, CA 94949-5344

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312329600000",
    "number": "1023396348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CALYPSO SHRS",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949495344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CALYPSO SHRS",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949495344",
            "telephone_number": "650-238-4033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC BREAST PATHOLOGY MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-03",
        "last_updated": "2011-08-03",
        "status": "A",
        "authorized_official_last_name": "DUTT",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "650-238-4033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novato, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.