Individual provider Active NPI

Alan Mare, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Hemet, CA
National Provider Identifier
1609889518
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
G10943 Issued in CA
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

Updated by the provider on Oct 19, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
00G109430MedicaidCA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091202000574 CA Practitioner - Pathology 1951409408

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10943CAMDAddiction (Substance Use Disorder) Counselor
G10943CAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.