YOSEMITE PATHOLOGY MEDICAL GROUP,INC (NPI# 1942475900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942475900 |
| Entity Type | Organization |
| Organization Name | YOSEMITE PATHOLOGY MEDICAL GROUP,INC |
| Practice Address |
350 S Oak Ave Oakdale CA 95361-3519 |
| Mailing Address |
Po Box 576768 Modesto CA 95357-6768 |
| Practice Telephone | 2095771200 |
| Practice Fax Number | 2095776517 |
| Mailing Telephone | 2095771200 |
| Mailing Fax Number | 2095776517 |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2008-04-29 |
| Authorized Official Name | ROBERT COLLETTI (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 2095771200 |
| Authorized Official Credential | MHA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 291U00000X | Clinical Medical Laboratory | G27612 | CA | Laboratories |
| Y | 291U00000X | Clinical Medical Laboratory | G27523 | CA | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0017744 | 05 |
| Street Address |
350 S OAK AVE |
| City | OAKDALE |
| State | CA |
| Zip Code | 95361-3519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184612483 | Brian Karl O'bannon | Physician Assistant | 350 S Oak Ave, Oakdale, CA 95361-3519 | 2005-10-11 |
| 1346620887 | Eric Jon Healy | Pharmacist | 350 S Oak Ave, Oakdale, CA 95361-3519 | 2015-05-30 |
| 1730567108 | Mabrook L. Shehata Md Medical Corporation | Specialist | 350 S Oak Ave, Oakdale, CA 95361-3519 | 2015-05-18 |
| 1669883278 | Geanny Ryan | Nurse Practitioner | 350 S Oak Ave, Oakdale, CA 95361-3519 | 2014-05-16 |
| 1417102716 | Oak Valley Hospital District | Ambulance | 350 S Oak Ave, Oakdale, CA 95361-3519 | 2008-12-01 |
| 1346381415 | Oak Valley Hospital District | Ambulance | 350 S Oak Ave, Oakdale, CA 95361-3519 | 2007-02-09 |
| 1003954694 | Max Mehrdad Maude | Physician Assistant | 350 S Oak Ave, Oakdale, CA 95361-3519 | 2007-02-03 |
| 1649317793 | Hong Kee Kim | Anesthesiology | 350 S Oak Ave, Oakdale, CA 95361-3519 | 2007-01-30 |
| 1598862054 | Oakdale Medical Group Inc | Emergency Medicine | 350 S Oak Ave, Oakdale, CA 95361-3519 | 2006-09-19 |
| 1750300372 | Bruce Baysin Chou | Anesthesiology | 350 S Oak Ave, Oakdale, CA 95361-3519 | 2006-07-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427453190 | Janet Kennedy Barretta | Marriage & Family Therapist | 210 South Sierra Suite 209 Serenity Heart Counseling Se, Oakdale, CA 95361 | 2014-10-23 |
| 1629483946 | Gina Maria Womack | Physical Therapy Assistant | 1570 E. F Street # N, Oakdale, CA 95361 | 2014-06-25 |
| 1457636946 | Eugene Awuah | Pharmacist | 2048 Royal Ascot Way, Oakdale, CA 95361 | 2011-10-15 |
| 1679852669 | Shiow-yan Chen | Pharmacist | 1449 East F Street Suite 102, Oakdale, CA 95361 | 2011-08-09 |
| 1659592475 | David Michael Meyers | Chiropractor | 715 West F Street, Oakdale, CA 95361 | 2007-05-01 |
| 1043372691 | Joanne Mccartney | Nurse Practitioner | 700 Laurel Avenue, Oakdale, CA 95361 | 2006-12-13 |
| 1457445587 | Suzanne Streater | Marriage & Family Therapist | 145 North Second Avenue, Suite 8, Oakdale, CA 95361 | 2006-10-03 |
| 1689786972 | Christina Louise Tourtlotte | Dentist | 1473 East G St, Ste C, Oakdale, CA 95361 | 2006-08-31 |
| 1750395042 | Janet R Busic | Psychologist | 7248 Gold Run Dr, Oakdale, CA 95361 | 2006-07-29 |
| 1609807346 | Consuelos S. Dizon | Anesthesiology | Oak Valley Hospital, 350 South Oak Ave., Oakdale, CA 95361 | 2006-07-05 |
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| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.