East Side Pathology Associates Medical Group, Inc.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

Legal business name

EAST SIDE PATHOLOGY ASSOCIATES MEDICAL GROUP, INC.

Practice address

5240 E Beverly Blvd
Los Angeles, CA 90022-2002

Phone

(626) 307-7875

Fax

(626) 307-7875

NPI assigned

Sep 8, 2005

Organization subpart

No

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

Authorized official

Name

Moises R Zepeda, M.D.NPI 1790779312

Title

President

Phone

(626) 307-7875

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Doctor'S Lab, LLC

  • Clinical Medical Laboratory
  • Monterey Park, CA
  • NPI 1629358916

  Member Of

  NPD member

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 1

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

• Moises R Zepeda, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Los Angeles, CA
  • NPI 1790779312
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398556800000",
    "number": "1184618878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5240 E BEVERLY BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900222002",
            "telephone_number": "626-307-7875",
            "fax_number": "626-307-7875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5240 E BEVERLY BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900222002",
            "telephone_number": "626-307-7875",
            "fax_number": "626-307-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST SIDE PATHOLOGY ASSOCIATES MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-08",
        "last_updated": "2014-04-27",
        "status": "A",
        "authorized_official_last_name": "ZEPEDA",
        "authorized_official_first_name": "MOISES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-307-7875",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East Los Angeles Health Task Force
• East Los Angeles Healthcare, LLC
• East Los Angeles Remarkable Citzens' Association, Inc.
• East Los Angeles Womens Center
• East Side Ketamine Specialists
• East Sunset Imaging Inc
• East Terrace Rehabilitation & Wellness Centre LP
• East West Drugs
• East-West Eye Institute a Medical Corporation
• East-West Eye Institute a Medical Corporation

• Anatomic Pathology & Clinical Pathology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Anatomic Pathology & Clinical Pathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.