Provider Demographics
NPI:1437236155
Name:PAVLOVICH, SASHA (MD,PHD)
Entity Type:Individual
Prefix:DR
First Name:SASHA
Middle Name:
Last Name:PAVLOVICH
Suffix:
Gender:M
Credentials:MD,PHD
Other - Prefix:
Other - First Name:SASA
Other - Middle Name:
Other - Last Name:PAVLOVIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:1980 S CAMINO REAL APT 10
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92264-9295
Mailing Address - Country:US
Mailing Address - Phone:773-827-4417
Mailing Address - Fax:
Practice Address - Street 1:207 W LEGION RD
Practice Address - Street 2:DEPT OF PATHOLOGY
Practice Address - City:BRAWLEY
Practice Address - State:CA
Practice Address - Zip Code:92227-7780
Practice Address - Country:US
Practice Address - Phone:760-351-3432
Practice Address - Fax:760-351-3702
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA113212207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology