Organization Active NPI

Path MD Inc

  • Clinical Medical Laboratory
  • Irvine, CA
National Provider Identifier
1124316138
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
PATH MD INC
Practice address
181 Technology Dr Ste 100B
Irvine, CA 92618-2484
Phone
(424) 302-3307
Fax
(818) 279-6939
NPI assigned
Jul 12, 2011
Last updated
Sep 22, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Authorized official

Name
Siamak TabibNPI 1063555845
Title
Owner
Phone
(310) 652-4472

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

181 Technology Dr Ste 100B
Irvine, CA 92618-2484

Mailing address

PO Box 745229
Los Angeles, CA 90074-5229
Phone (424) 302-3307

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20121121000238 CA Part B Supplier - Independent Clinical Laboratory 1759532781 Practice locations: Duarte, CA
O20140718001941 CA Part B Supplier - Clinic/Group Practice 1759532781 Receives reassigned benefits from 22 practitioners
Practice locations: Duarte, CA
O20240812000047 TX Part B Supplier - Independent Clinical Laboratory 1759532781 Practice locations: Farmers Branch, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0555414Georgette Tadros MD931 Buena Vista Ave Suite #202, Duarte, CA 91010Certificate of waiverAug 31, 2026
05D2045519Path MD931 Buena Vista St Ste 200a, Duarte, CA 91010AccreditationFeb 3, 2027

National Provider Directory

National Provider Directory

Locations

931 Buena Vista St
Ste 200A
Duarte, CA 91010
Phone (818) 321-2745

8 Medical Pkwy
Ste 306A
Farmers Brnch, TX 75234
Phone (469) 722-1906

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1310428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790035200000",
    "number": "1124316138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 745229",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900745229",
            "telephone_number": "424-302-3307",
            "fax_number": "818-279-6939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 TECHNOLOGY DR STE 100B",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182484",
            "telephone_number": "424-302-3307",
            "fax_number": "818-279-6939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATH MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-12",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A",
        "authorized_official_last_name": "TABIB",
        "authorized_official_first_name": "SIAMAK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-652-4472"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.