Provider Demographics
NPI:1083185342
Name:PALM PATHOLOGY MEDICAL GROUP, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:PALM PATHOLOGY MEDICAL GROUP, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOLINE
Authorized Official - Middle Name:H
Authorized Official - Last Name:ABRAHAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-333-8591
Mailing Address - Street 1:1150 N INDIAN CANYON DR
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-4872
Mailing Address - Country:US
Mailing Address - Phone:760-323-6198
Mailing Address - Fax:760-323-6195
Practice Address - Street 1:1150 N INDIAN CANYON DR
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4872
Practice Address - Country:US
Practice Address - Phone:760-323-6198
Practice Address - Fax:760-323-6195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty