Magnolia Pathology Medical Group, Inc.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

Legal business name

MAGNOLIA PATHOLOGY MEDICAL GROUP, INC.

Practice address

3865 Jackson St
Dept of Pathology
Riverside, CA 92503-3919

Phone

(951) 352-5301

Fax

(951) 352-5340

NPI assigned

Mar 16, 2006

Organization subpart

No

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

Authorized official

Name

Catherine Odell, M.D.

Title

President

Phone

(951) 352-5301

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565827200000",
    "number": "1316916810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2245",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925162245",
            "telephone_number": "661-705-3441",
            "fax_number": "951-848-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3865 JACKSON ST",
            "address_2": "DEPT OF PATHOLOGY",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033919",
            "telephone_number": "951-352-5301",
            "fax_number": "951-352-5340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA PATHOLOGY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-16",
        "last_updated": "2019-08-15",
        "status": "A",
        "authorized_official_last_name": "ODELL",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-352-5301",
        "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "AW462A",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP PTAN",
            "identifier": "DO4317",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John R Magner, PSYCHOLOGIST
• Aubrie Magness
• Nancy Shoukry Magness, MD
• Joy Gozum Magno, FNP
• Magnolia Acute Trauma, a Medical Corporation
• Magnolia Surgery Center,Inc.
• Magnolia Women's Center
• Janelle Magpayo, OT
• Gillian Maguire
• Ali Abdulraheem Mahdi

• Anatomic Pathology & Clinical Pathology Physician in Riverside, CA
• Providers in Riverside, 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 Aug 15, 2019; 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.