Active NPI
Alan Mare, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Hemet, CA
National Provider Identifier
1609889518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- G10943
- Practice address
- 1117 E Devonshire Ave
Hemet, CA 92543-3083 - Phone
- (951) 925-6317
- Fax
- (951) 765-4829
- NPI assigned
- Aug 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology Physician | 207ZP0101X | G10943 | CA | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | G10943 | CA | Primary |
Addresses
Primary practice location
1117 E Devonshire Ave
Hemet, CA 92543-3083
Mailing address
PO Box 6388
San Pedro, CA 90734-6388
Phone (310) 225-3244
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G109430 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091202000574 | CA | Practitioner - Pathology | 1951409408 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10943 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| G10943 | CA | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Affiliated Pathologists Medical Group, Inc. | Anatomic Pathology | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Anatomic Pathology & Clinical Pathology Physician
- Rancho Dominguez, CA
- NPI 1730119553
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192752000000",
"number": "1609889518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6388",
"city": "SAN PEDRO",
"state": "CA",
"postal_code": "907346388",
"telephone_number": "310-225-3244",
"fax_number": "310-225-3244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1117 E DEVONSHIRE AVE",
"city": "HEMET",
"state": "CA",
"postal_code": "925433083",
"telephone_number": "951-925-6317",
"fax_number": "951-765-4829"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARE",
"first_name": "ALAN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-14",
"last_updated": "2007-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0101X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology",
"state": "CA",
"license": "G10943",
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "CA",
"license": "G10943",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G109430",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hemet, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.