Provider Demographics
NPI:1407346232
Name:CARTESIAN MEDICAL GROUP, INC.
Entity type:Organization
Organization Name:CARTESIAN MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CMO
Authorized Official - Prefix:DR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:DENTON
Authorized Official - Last Name:LYLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-516-5145
Mailing Address - Street 1:2110 RUTHERFORD RD
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-7328
Mailing Address - Country:US
Mailing Address - Phone:800-755-1605
Mailing Address - Fax:760-268-6201
Practice Address - Street 1:2110 RUTHERFORD RD
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-7328
Practice Address - Country:US
Practice Address - Phone:800-755-1605
Practice Address - Fax:760-268-6201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-17
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty