NPIMap

Organization Active NPI

San Gabriel Valley Consulting Pathologists Medical Group, Inc.

  • Anatomic Pathology & Clinical Pathology Physician
  • West Covina, CA
National Provider Identifier
1851352256
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
SAN GABRIEL VALLEY CONSULTING PATHOLOGISTS MEDICAL GROUP, INC.
Practice address
1115 S Sunset Ave
West Covina, CA 91790-3940
Phone
(626) 573-5324
NPI assigned
Mar 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Authorized official

Name
Arthur H Williams, MDNPI 1578524617
Title
President
Phone
(626) 573-5324

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZC0500X
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

1115 S Sunset Ave
West Covina, CA 91790-3940

Mailing address

PO Box 10076
Van Nuys, CA 91410-0076
Phone (805) 578-8300

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ07756ZOtherCABLUE SHIELD
GR0027243MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000750 CA Part B Supplier - Clinic/Group Practice 5597678805 Receives reassigned benefits from 17 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Glendora, CA; West Covina, CA; South El Monte, CA; San Gabriel, CA; Monterey Park, CA; Los Angeles, CA

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
San Gabriel Valley Consulting Pathologists Medical Group Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698105600000",
    "number": "1851352256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10076",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914100076",
            "telephone_number": "805-578-8300",
            "fax_number": "805-578-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 S SUNSET AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903940",
            "telephone_number": "626-573-5324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN GABRIEL VALLEY CONSULTING PATHOLOGISTS MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-573-5324",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Cytopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ07756Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0027243",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.