NPIMap

Organization Active NPI

Yosemite Pathology Medical Group, Inc

  • Clinical Medical Laboratory
  • Sonora, CA
National Provider Identifier
1760657092
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
G37943 Issued in CA
Legal business name
YOSEMITE PATHOLOGY MEDICAL GROUP, INC
Practice address
1000 Greenley Rd
Sonora, CA 95370-5200
Phone
(209) 577-1200
Fax
(209) 577-6517
NPI assigned
Apr 28, 2008
Last updated
Apr 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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

Authorized official

Name
Robert Colletti, MHA
Title
Chief Operating Officer
Phone
(209) 577-1200

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X A24567 CA
Clinical Medical Laboratory 291U00000X G66626 CA
Clinical Medical Laboratory 291U00000X G37943 CA Primary

Addresses

Primary practice location

1000 Greenley Rd
Sonora, CA 95370-5200

Mailing address

PO Box 576768
Modesto, CA 95357-6768
Phone (209) 577-1200

Other identifiers 1

IdentifierTypeStateIssuer
GR001774AMedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Yosemite Path Med GRP I9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209340800000",
    "number": "1760657092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 576768",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953576768",
            "telephone_number": "209-577-1200",
            "fax_number": "209-577-6517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 GREENLEY RD",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705200",
            "telephone_number": "209-577-1200",
            "fax_number": "209-577-6517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOSEMITE PATHOLOGY MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-28",
        "last_updated": "2008-04-28",
        "status": "A",
        "authorized_official_last_name": "COLLETTI",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "209-577-1200",
        "authorized_official_credential": "MHA"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "A24567",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "G66626",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "G37943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR001774A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sonora, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.