Applied Pathology Medical Associates

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

CLF4029 Issued in CA

Legal business name

APPLIED PATHOLOGY MEDICAL ASSOCIATES

Practice address

81-715 Dr Carreon Blvd
Ste A2
Indio, CA 92201-5526

Phone

(760) 347-8947

Fax

(760) 347-2542

NPI assigned

Mar 1, 2006

Last updated

Jun 12, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

William R Starke, MD

Title

Owner Director

Phone

(760) 347-8947

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213228800000",
    "number": "1972570620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81-715 DR CARREON BLVD",
            "address_2": "STE A2",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015526",
            "telephone_number": "760-347-8947",
            "fax_number": "760-347-2542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81-715 DR CARREON BLVD",
            "address_2": "STE A2",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015526",
            "telephone_number": "760-347-8947",
            "fax_number": "760-347-2542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPLIED PATHOLOGY MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-01",
        "last_updated": "2008-06-12",
        "status": "A",
        "authorized_official_last_name": "STARKE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER DIRECTOR",
        "authorized_official_telephone_number": "760-347-8947",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "CLF4029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LAB ID",
            "identifier": "CLF4029",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D0643136",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAB43136F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Talitha Elizabeth Archer

• Clinical Medical Laboratory in Indio, CA
• Providers in Indio, 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 Jun 12, 2008; 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.