Individual provider Active NPI

Stephen Dongjin Oh, D.O.

  • Anatomic Pathology & Clinical Pathology Physician
  • Murrieta, CA
National Provider Identifier
1881867695
Registry record updated Nov 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
20A 9711 Issued in CA
Practice address
29185 Branwin St
Murrieta, CA 92563-5877
Phone
(312) 636-9389
Fax
(951) 200-6797
NPI assigned
Apr 12, 2008
Last updated
Nov 28, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 20A 9711 CA Primary

Addresses

Primary practice location

29185 Branwin St
Murrieta, CA 92563-5877

Mailing address

29185 Branwin St
Murrieta, CA 92563-5877
Phone (312) 636-9389

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100125000664 CA Practitioner - Pathology 5799827077 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A 9711CAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Laboratory Services Medical Group, Inc. Anatomic Pathology & Clinical Pathology Current Accepting new patients
Medical Laboratory Services Medical Group Inc Anatomic Pathology & Clinical Pathology CurrentSince Dec 4, 2009 Accepting new patients
Medical Laboratory Services Medical Group, Inc. CurrentSince Dec 4, 2009 Accepting new patients

Locations

25470 Medical Center Dr
Ste 105
Murrieta, CA 92562
Phone (951) 834-9025

40663 Murrieta Hot Springs Rd
Ste C1
Murrieta, CA 92562
Phone (951) 200-6791

36485 Inland Valley Dr
Wildomar, CA 92595
Phone (909) 677-9778

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1207958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480291200000",
    "number": "1881867695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29185 BRANWIN ST",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925635877",
            "telephone_number": "312-636-9389",
            "fax_number": "951-200-6797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29185 BRANWIN ST",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925635877",
            "telephone_number": "312-636-9389",
            "fax_number": "951-200-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OH",
        "first_name": "STEPHEN",
        "middle_name": "DONGJIN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-12",
        "last_updated": "2016-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "20A 9711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

Verify at the official NPI Registry.