Delta Pathology Associates Medical Group Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

05D0609388 Issued in CA

Legal business name

DELTA PATHOLOGY ASSOCIATES MEDICAL GROUP INC

Practice address

3133 W March LN
Suite 1040
Stockton, CA 95219-2336

Phone

(209) 477-4432

Fax

(209) 320-6136

NPI assigned

Mar 9, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Albert K. Siu, M.D.NPI 1710955364

Title

Owner

Phone

(209) 477-4432

Specialties & licenses 12

Addresses

Other identifiers 2

Locations

Practitioners 3

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

• Albert K.Q. Siu, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Modesto, CA
  • NPI 1710955364

  Blood Banking & Transfusion Medicine

  NPD Authorized official
• Carl Herrick Critz, MD

  • Cytopathology Physician
  • San Ramon, CA
  • NPI 1740232107
  NPD (past)
• Robert D Lawrence, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Stockton, CA
  • NPI 1033187158
  NPD (past)

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284163200000",
    "number": "1306814918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 77800",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952671100",
            "telephone_number": "209-477-4432",
            "fax_number": "209-320-6136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3133 W MARCH LN",
            "address_2": "SUITE 1040",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952192336",
            "telephone_number": "209-477-4432",
            "fax_number": "209-320-6136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA PATHOLOGY ASSOCIATES MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-09",
        "last_updated": "2010-09-11",
        "status": "A",
        "authorized_official_last_name": "SIU",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-477-4432",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZB0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "CA",
            "license": "05D0609388",
            "primary": false
        },
        {
            "code": "207ZC0500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Cytopathology",
            "state": "CA",
            "license": "05D0609388",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Dermatopathology",
            "state": "CA",
            "license": "05D0609388",
            "primary": false
        },
        {
            "code": "207ZH0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Hematology",
            "state": "CA",
            "license": "05D0609388",
            "primary": false
        },
        {
            "code": "207ZI0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Immunopathology",
            "state": "CA",
            "license": "05D0609388",
            "primary": false
        },
        {
            "code": "207ZM0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Medical Microbiology",
            "state": "CA",
            "license": "05D0609388",
            "primary": false
        },
        {
            "code": "207ZN0500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Neuropathology",
            "state": "CA",
            "license": "05D0609388",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "05D0609388",
            "primary": false
        },
        {
            "code": "207ZP0104X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Chemical Pathology",
            "state": "CA",
            "license": "05D0609388",
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "CA",
            "license": "05D0609388",
            "primary": false
        },
        {
            "code": "207ZP0213X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Pediatric Pathology",
            "state": "CA",
            "license": "05D0609388",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "05D0609388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "220010681",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAB09388F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Stockton, CA
• Providers in Stockton, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2010; 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.