1316970932

Everything you always wanted to know about CMCLA PATHOLOGY MEDICAL GROUP NACHAZEL JOHN but were afraid to ask.

CMCLA PATHOLOGY MEDICAL GROUP NACHAZEL JOHN

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Organization Name Authorized Official Last Name Authorized Official First Name
CMCLA PATHOLOGY MEDICAL GROUP NACHAZEL JOHN
Gender:
none
Enumeration date:
2006-07-08
Last update date:
2014-06-03
Current as of:
2007-08-28
Is sole proprietor?:
Not Answered
Is organization subpart?:
No
In PECOS?:
No

Identifiers

identifier description issuer state active
HW12241 Medicare ID-Type Undpecified none CA 1
GR0059120 Medicaid none CA 1

Taxonomies

Taxonomy State License Number Primary?
207ZP0102X Anatomic Pathology & Clinical Pathology none none

Phone Numbers

Type Number
Mailing Address Telephone Number 8002888325
Practice Location Address Telephone Number 2137425793
Authorized Official Telephone Number 2137425793
Mailing Address Fax Number 4198665453
Practice Location Address Fax Number 4198665453

Addresses

Type Address City State Postal Country
Mailing Address 5700 SOUTHWYCK BLVD TOLEDO OH 43614 OH
Practice Location Address 1401 SOUTH GRAND AVENUE LOS ANGELES CA 0 CA

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