Onco Diagnostic Laboratory

Primary specialty

Anatomic Pathology PhysicianTaxonomy code 207ZP0101X

License

35031213 Issued in OH

Legal business name

ONCO DIAGNOSTIC LABORATORY

Practice address

812 Huron Rd E
Suite 520
Cleveland, OH 44115-1123

Phone

(216) 861-5846

Fax

(216) 861-1720

NPI assigned

Jun 29, 2006

Last updated

Jul 22, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Chanho H Park, M.D.

Title

Medical Director

Phone

(706) 546-0200

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311292800000",
    "number": "1386672277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 72501",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441920501",
            "telephone_number": "706-546-0200",
            "fax_number": "706-546-6522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 HURON RD E",
            "address_2": "SUITE 520",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441151123",
            "telephone_number": "216-861-5846",
            "fax_number": "216-861-1720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONCO DIAGNOSTIC LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2011-07-22",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "CHANHO",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "706-546-0200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology",
            "state": "OH",
            "license": "35031213",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "OH",
            "license": "36D0656045",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0893547",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Anatomic Pathology Physician in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Anatomic Pathology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2011; 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.