Provider Demographics
NPI:1396161014
Name:CONTRA COSTA PATHOLOGY ASSOCIATES
Entity type:Organization
Organization Name:CONTRA COSTA PATHOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:P
Authorized Official - Last Name:LATNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-270-3575
Mailing Address - Street 1:P.O. BOX 1440
Mailing Address - Street 2:
Mailing Address - City:SUISUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94585
Mailing Address - Country:US
Mailing Address - Phone:510-964-0458
Mailing Address - Fax:510-964-0476
Practice Address - Street 1:399 TAYLOR BLVD SW 200
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523
Practice Address - Country:US
Practice Address - Phone:925-270-3575
Practice Address - Fax:925-270-3589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-06
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207ZC0500X, 207ZP0102X, 207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathologyGroup - Single Specialty
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathologyGroup - Single Specialty
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ28491ZMedicare PIN