Provider Demographics
NPI:1972807683
Name:PESCE, AMADEO (PHD)
Entity Type:Individual
Prefix:
First Name:AMADEO
Middle Name:
Last Name:PESCE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 841773
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-1773
Mailing Address - Country:US
Mailing Address - Phone:805-578-8300
Mailing Address - Fax:805-578-3911
Practice Address - Street 1:16981 VIA TAZON
Practice Address - Street 2:SUITE F
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-1645
Practice Address - Country:US
Practice Address - Phone:858-451-3535
Practice Address - Fax:858-451-3636
Is Sole Proprietor?:No
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADRI-100000098207ZP0104X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0104XAllopathic & Osteopathic PhysiciansPathologyChemical Pathology