Pacific Pathology, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

CLF 10272 Issued in CA

Legal business name

PACIFIC PATHOLOGY, INC.

Practice address

9292 Chesapeake Drive
Suite 100
San Diego, CA 92123-1059

Phone

(858) 576-9960

Fax

(858) 576-6857

NPI assigned

Jul 27, 2006

Organization subpart

No

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

Authorized official

Name

Dr. John B. Campbell, M.D.

Title

Director

Phone

(858) 576-9960

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Pacific Pathology, Inc.

  • Anatomic Pathology & Clinical Pathology Physician
  • San Diego, CA
  • NPI 1457377541

  9436187861

  Same PAC ID

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": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430697600000",
    "number": "1881618288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9292 CHESAPEAKE DRIVE",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231059",
            "telephone_number": "858-576-9960",
            "fax_number": "858-576-6857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9292 CHESAPEAKE DRIVE",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231059",
            "telephone_number": "858-576-9960",
            "fax_number": "858-576-6857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC PATHOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2015-05-04",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "858-576-9960",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "CLF 10272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0055390",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pacific Medical/Bay Recovery
• Pacific Mindscape Medical Group
• Pacific Neurobehavioral Clinic: a Psychological Corporation
• Pacific Neurology AMC
• Pacific Pathology, Inc.
• Pacific Podiatry Consultants Inc
• Pacific Point HCS, Inc.
• Pacific Point Health Care Services Inc
• Pacific Point Health Care Services, Inc.
• Pacific Point Health Care Services, Inc.

• Clinical Medical Laboratory in San Diego, CA
• Providers in San Diego, 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 4, 2015; 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.