Pacific Avenue Medical Laboratory, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

CLF 4446 Issued in CA

Legal business name

PACIFIC AVENUE MEDICAL LABORATORY, INC.

Practice address

728 Pacific Ave
Suite #401
San Francisco, CA 94133-4457

Phone

(415) 982-8828

Fax

(415) 982-8831

NPI assigned

Feb 13, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Joann Owyang, CLS

Title

Laboratory Manager/Owner

Phone

(415) 982-8828

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801869524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 PACIFIC AVE",
            "address_2": "SUITE #401",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941334457",
            "telephone_number": "415-982-8828",
            "fax_number": "415-982-8831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 PACIFIC AVE",
            "address_2": "SUITE #401",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941334457",
            "telephone_number": "415-982-8828",
            "fax_number": "415-982-8831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC AVENUE MEDICAL LABORATORY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OWYANG",
        "authorized_official_first_name": "JOANN",
        "authorized_official_title_or_position": "LABORATORY MANAGER/OWNER",
        "authorized_official_telephone_number": "415-982-8828",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CLS"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "CLF 4446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAB58442F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary J Pacheco, PHD
• Melissa A Pacheco
• Elizaveta Pachepsky, LMFT
• Natalia Pachote
• Pacific Audiology Inc.
• Pacific Childrens Eyecare Medical Group
• Pacific Cognitive Behavioral Therapy (Pacific CBT)
• Pacific Cognitive Health, a Professional Psychological Corporation
• Pacific Crest Orthopedics PC
• Pacific Dental Associates

• Clinical Medical Laboratory in San Francisco, CA
• Providers in San Francisco, 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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.