Provider Demographics
NPI:1154643286
Name:TMA PATHOLOGY SERVICES
Entity Type:Organization
Organization Name:TMA PATHOLOGY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:G
Authorized Official - Last Name:HIROSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-373-5700
Mailing Address - Street 1:647 CAMINO DE LOS MARES
Mailing Address - Street 2:223
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-2825
Mailing Address - Country:US
Mailing Address - Phone:949-487-5100
Mailing Address - Fax:949-487-7065
Practice Address - Street 1:647 CAMINO DE LOS MARES
Practice Address - Street 2:223
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-2825
Practice Address - Country:US
Practice Address - Phone:949-487-5100
Practice Address - Fax:949-487-7065
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THOMAS G. HIROSE,M.D. APC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-16
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG66676207ZB0001X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
No207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion MedicineGroup - Single Specialty