Organization Active NPI

Valley Pathology Medical Group

  • Anatomic Pathology & Clinical Pathology Physician
  • Hemet, CA
National Provider Identifier
1275546129
Registry record updated Aug 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
VALLEY PATHOLOGY MEDICAL GROUP
Practice address
1117 E Devonshire Ave
Hemet, CA 92543-3083
Phone
(951) 925-6383
Fax
(951) 765-4829
NPI assigned
Aug 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2009

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

Authorized official

Name
Alan Mare, M.D.
Title
Pathologist
Phone
(951) 925-6383

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X CA Primary

Addresses

Primary practice location

1117 E Devonshire Ave
Hemet, CA 92543-3083

Mailing address

1117 E Devonshire Ave
Hemet, CA 92543-3083
Phone (951) 925-6383

Other identifiers 3

IdentifierTypeStateIssuer
GR0071512MedicaidCA
GR0071510MedicaidCA
GR0071511MedicaidCA

National Provider Directory

National Provider Directory

Locations

395 N San Jacinto St
#3C
Hemet, CA 92543
Phone (714) 774-7470

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249862400000",
    "number": "1275546129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 E DEVONSHIRE AVE",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925433083",
            "telephone_number": "951-925-6383",
            "fax_number": "951-765-4829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 E DEVONSHIRE AVE",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925433083",
            "telephone_number": "951-925-6383",
            "fax_number": "951-765-4829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY PATHOLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2009-08-10",
        "status": "A",
        "authorized_official_last_name": "MARE",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "PATHOLOGIST",
        "authorized_official_telephone_number": "951-925-6383",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0071512",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0071510",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0071511",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hemet, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2009; 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.