NPIMap

Organization Active NPI

Western Laboratories

  • Anatomic Pathology & Clinical Pathology Physician
  • Alameda, CA
National Provider Identifier
1689636797
Registry record updated Apr 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
WESTERN LABORATORIES
Practice address
2070 Clinton Ave
Alameda, CA 94501-4320
Phone
(510) 814-4305
NPI assigned
Apr 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2017

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

Authorized official

Name
Elizabeth Treynor, MDNPI 1750343851
Title
Managing Partner
Phone
(510) 814-4305

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

2070 Clinton Ave
Alameda, CA 94501-4320

Mailing address

5700 Southwyck Blvd
Toledo, OH 43614-1509
Phone (800) 288-8325

Other identifiers 1

IdentifierTypeStateIssuer
GR0014622MedicaidCA

Other names 1

  • Western Laboratory Medical Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031210000669 CA Part B Supplier - Clinic/Group Practice 2769388776 Receives reassigned benefits from 8 practitioners
2 other NPIs on this enrollment
Practice locations: Alameda, CA; Fremont, CA; Hayward, CA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Western Laboratories3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 8

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": "1144108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491955200000",
    "number": "1689636797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141509",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2070 CLINTON AVE",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945014320",
            "telephone_number": "510-814-4305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN LABORATORIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-04",
        "last_updated": "2017-04-12",
        "status": "A",
        "authorized_official_last_name": "TREYNOR",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "510-814-4305",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0014622",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Western Laboratory Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alameda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.