Organization Active NPI

California Pathology Medical Group

  • Anatomic Pathology Physician
  • Pleasanton, CA
National Provider Identifier
1477582161
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
Legal business name
CALIFORNIA PATHOLOGY MEDICAL GROUP
Practice address
5555 W Las Positas Blvd
Pleasanton, CA 94588-4000
Phone
(209) 473-6555
Fax
(209) 473-6544
NPI assigned
Jul 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
David Enfield
Title
Managing Partner
Phone
(209) 473-6555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0101X Primary

Addresses

Primary practice location

5555 W Las Positas Blvd
Pleasanton, CA 94588-4000

Mailing address

3116 W March LN Ste 200
Stockton, CA 95219-2370
Phone (209) 473-6555

Other identifiers 2

IdentifierTypeStateIssuer
GR0090470MedicaidCA
P00116598OtherCAMEDICARE RAILROAD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477582161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3116 W MARCH LN STE 200",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952192370",
            "telephone_number": "209-473-6555",
            "fax_number": "209-473-6544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 W LAS POSITAS BLVD",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945884000",
            "telephone_number": "209-473-6555",
            "fax_number": "209-473-6544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA PATHOLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ENFIELD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "209-473-6555"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0090470",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00116598",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.