Pathsynergy

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

CLF 00345706 Issued in CA

Legal business name

PATHSYNERGY

Practice address

13922 Mennonite PT
San Diego, CA 92129-3134

Phone

(203) 506-7862

NPI assigned

Nov 14, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Sepi Mahooti, M.D.

Title

President & C.E.O

Phone

(203) 506-7862

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1415923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415923200000",
    "number": "1972909224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13922 MENNONITE PT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921293134",
            "telephone_number": "203-506-7862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13922 MENNONITE PT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921293134",
            "telephone_number": "203-506-7862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHSYNERGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-14",
        "last_updated": "2014-11-14",
        "status": "A",
        "authorized_official_last_name": "MAHOOTI",
        "authorized_official_first_name": "SEPI",
        "authorized_official_title_or_position": "PRESIDENT & C.E.O",
        "authorized_official_telephone_number": "203-506-7862",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "CLF 00345706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "CLF 00345706",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D2073518",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• 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 Nov 14, 2014; 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.