Provider Demographics
NPI:1972080752
Name:BORIS SHLOPOV MD PATHOLOGY MEDICAL CORPORATION
Entity type:Organization
Organization Name:BORIS SHLOPOV MD PATHOLOGY MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SHLOPOV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-736-6383
Mailing Address - Street 1:PO BOX 104231
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91189-4231
Mailing Address - Country:US
Mailing Address - Phone:951-736-6383
Mailing Address - Fax:
Practice Address - Street 1:800 S MAIN
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882
Practice Address - Country:US
Practice Address - Phone:951-736-6383
Practice Address - Fax:909-736-6384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-24
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty