Pangea Laboratory LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PANGEA LABORATORY LLC

Practice address

14762 Bentley Cir
Tustin, CA 92780-7226

Phone

(949) 346-9393

NPI assigned

Jun 5, 2020

Organization subpart

No

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

Authorized official

Name

Yap Chew

Title

Administrator

Phone

(949) 346-9393

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 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

Locations

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684454400000",
    "number": "1851915888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14762 BENTLEY CIR",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927807226",
            "telephone_number": "493-469-3939",
            "fax_number": "813-642-4907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14762 BENTLEY CIR",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927807226",
            "telephone_number": "949-346-9393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANGEA LABORATORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-05",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A",
        "authorized_official_last_name": "CHEW",
        "authorized_official_first_name": "YAP",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "949-346-9393"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT CLINICAL LABORATORY",
            "identifier": "05D2120654",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skincer@medicalpracticepartner.com",
            "affiliation": "N",
            "address_1": "14762 Bentley Cir",
            "city": "Tustin",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927807226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Young Joon Pak, PHARMD
• Roberto C Palacios
• Edward James Pallotta Jr., PH.D.
• Christina Cecilia Palmer, FNP
• Matthew Alan Palmer
• Panorama Marriage and Family Counseling, a Professional Corporation
• Jacqueline Paquette, DMD
• Michael Paquette, D.D.S.
• Yasmeen Pardo
• Christopher C Park, CPO

• 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 May 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.