Pediatric Pathology Medical Group, Inc

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

G18364 Issued in CA

Legal business name

PEDIATRIC PATHOLOGY MEDICAL GROUP, INC

Practice address

9300 Valley Childrens PL
Madera, CA 93638-8761

Phone

(559) 353-6103

NPI assigned

Jan 3, 2007

Organization subpart

No

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

Authorized official

Name

Stephen H Kassel, M. D.

Title

Ceo

Phone

(559) 999-8583

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831256031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3116 W MARCH LN",
            "address_2": "SUITE 200",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952192369",
            "telephone_number": "209-473-6555",
            "fax_number": "209-473-6543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 VALLEY CHILDRENS PL",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936388761",
            "telephone_number": "559-353-6103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PATHOLOGY MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KASSEL",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "559-999-8583",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "G18364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexa Patton
• Jennifer Paul, LCSW
• Dhakshitha Peddisetty, MD
• Pediatric Anesthesia Associates Medical Group Inc
• Pediatric Gastroenterology Consultants
• Tim G. Peffly, D.D.S.
• Itzayana Pelayo, ACSW
• Sahithi Pemmasani
• Ria Peralta, DO
• Abel Perez

• Anatomic Pathology & Clinical Pathology Physician in Madera, CA
• Providers in Madera, CA by specialty
• Anatomic Pathology & Clinical Pathology Physician 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.