Provider Demographics
NPI:1093572539
Name:LOS PALOS PATHOLOGY LAB AND ANCILLARY SERVICES INC
Entity Type:Organization
Organization Name:LOS PALOS PATHOLOGY LAB AND ANCILLARY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:RAQUEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:SISAYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-594-1537
Mailing Address - Street 1:1083 LOS PALOS DR
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-3916
Mailing Address - Country:US
Mailing Address - Phone:831-594-1537
Mailing Address - Fax:831-998-7155
Practice Address - Street 1:1083 LOS PALOS DR
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3916
Practice Address - Country:US
Practice Address - Phone:831-594-1537
Practice Address - Fax:831-998-7155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty