St. Vincent Pathology Medical Group
Organization Active NPI Cytopathology Physician · Los Angeles, CA
NPI 1689635773 · NPPES record last updated Sep 14, 2022
Key facts
- NPI
- 1689635773
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Cytopathology Physician 207ZC0500X
- Legal business name
- ST. VINCENT PATHOLOGY MEDICAL GROUP
- Practice address
- 1300 N Vermont Ave
Los Angeles, CA 90027-6098 - Phone
- (323) 913-4934
- NPI assigned
- Mar 29, 2006
- Organization subpart
- No
Authorized official
- Name
- Lu Conrad Jr., MD
- Title
- President
- Phone
- (323) 913-4934
Practitioners 4
-
Hien Huynh, M.D.
-
Conrad H Lu, MD
-
Sanaz Ainechi, MD
-
Hongying Tan, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040206000742 | CA | Part B Supplier - Clinic/Group Practice | 7214820778 |
Receives reassigned benefits from 4 practitioners Practice locations: Los Angeles, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cytopathology Physician |
207ZC0500X | Yes |
Addresses
Primary practice location
1300 N Vermont Ave
Los Angeles, CA 90027-6098
Mailing address
5700 Southwyck Blvd
Toledo, OH 43614-1509
Phone (800) 288-8325
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0052810 | Medicaid | CA |
Other providers in Los Angeles, CA
- St. Paul Center Alcohol and Drug Program
- St. Vincent Anesthesia Medical Group, Inc.
- St. Vincent Dialysis Center, Inc.
- St. Vincent Medical Center
- St. Vincent Medical Center
- St.Nectarios Hospice, Inc.
- Nicholas St.Pierre
- Czar J Sta Ana
- Sta Management Inc.
- Merry Ann Sabiaga Sta Maria
All providers in Los Angeles, CA · Cytopathology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.