Histopathology Services Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

HISTOPATHOLOGY SERVICES INC

Practice address

15012 Red Hill Ave
Suite 8H
Tustin, CA 92780-6524

Phone

(949) 415-2535

NPI assigned

Oct 15, 2010

Organization subpart

No

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

Authorized official

Name

Khodadad Mehraein, MDNPI 1316147374

Title

President/Ceo

Phone

(949) 415-2535

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Khodadad Mehraein, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Santa Ana, CA
  • NPI 1316147374
  NPD Authorized official

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413936000000",
    "number": "1699085290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15012 RED HILL AVENUE",
            "address_2": "SUITE 8H",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "92780",
            "telephone_number": "949-415-2535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15012 RED HILL AVE",
            "address_2": "SUITE 8H",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806524",
            "telephone_number": "949-415-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HISTOPATHOLOGY SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-15",
        "last_updated": "2014-10-22",
        "status": "A",
        "authorized_official_last_name": "MEHRAEIN",
        "authorized_official_first_name": "KHODADAD",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "949-415-2535",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLF",
            "identifier": "339775",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D2009046",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Tustin, CA
• Providers in Tustin, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; 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.