Provider Demographics
NPI:1659633493
Name:PATHOLOGY ASSOCIATES OF ARCADIA
Entity Type:Organization
Organization Name:PATHOLOGY ASSOCIATES OF ARCADIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:PARAKRAMA
Authorized Official - Middle Name:T
Authorized Official - Last Name:CHANDRASOMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-409-4600
Mailing Address - Street 1:405 LINDA VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-1237
Mailing Address - Country:US
Mailing Address - Phone:323-409-4600
Mailing Address - Fax:323-441-8183
Practice Address - Street 1:405 LINDA VISTA AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-1237
Practice Address - Country:US
Practice Address - Phone:323-409-4600
Practice Address - Fax:323-441-8183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34284207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty