Active NPI
Cag Group PC
- Clinical Medical Laboratory
- Baltimore, MD
National Provider Identifier
1447585120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- License
- 21D0649684
- Legal business name
- CAG GROUP PC
- Doing business as
- dermatopathology consultation services
- Practice address
- 1319 Park Ave
Baltimore, MD 21217-4104 - Phone
- (443) 927-7364
- Fax
- (800) 419-7485
- NPI assigned
- Oct 13, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Maurice M Vincent, MD
- Title
- President
- Phone
- (443) 927-7364
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 21D0649684 | MD | Primary |
Addresses
Primary practice location
1319 Park Ave
Baltimore, MD 21217-4104
Mailing address
7095 Hollywood Blvd
Suite 338
Hollywood, CA 90028-8903
Phone (443) 927-7364
Other names 1
- dermatopathology consultation services
National Provider Directory
National Provider DirectoryLocations
7095 Hollywood Blvd
Ste 338
Hollywood, CA 90028
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255392000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1255392000000",
"number": "1447585120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7095 HOLLYWOOD BLVD",
"address_2": "SUITE 338",
"city": "HOLLYWOOD",
"state": "CA",
"postal_code": "900288903",
"telephone_number": "443-927-7364",
"fax_number": "800-419-7485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1319 PARK AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212174104",
"telephone_number": "443-927-7364",
"fax_number": "800-419-7485"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CAG GROUP PC",
"organizational_subpart": "NO",
"enumeration_date": "2009-10-13",
"last_updated": "2009-10-13",
"status": "A",
"authorized_official_last_name": "VINCENT",
"authorized_official_first_name": "MAURICE",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "443-927-7364",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "MD",
"license": "21D0649684",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "dermatopathology consultation services",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.