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INTERSCOPE PATHOLOGY MEDICAL GROUP INC
NPI 1104830074
Pathology - Anatomic Pathology & Clinical Pathology in Westlake Village, CA

Active since July 28, 2006
30700 RUSSELL RANCH RD SUITE 250, UNIT 235, WESTLAKE VILLAGE, CA 91362(818) 992-7848(818) 992-7748 Get Directions Write a Review

NPPES record last updated: January 5, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 5, 2026, May 18, 2023, Feb 13, 2017 (3 updates tracked since 2017).

About Interscope Pathology Medical Group Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INTERSCOPE PATHOLOGY MEDICAL GROUP INC (NPI 1104830074) is a healthcare organization registered as an anatomic pathology & clinical pathology in Westlake Village, California and active in the NPI registry since July 2006. The organization lists Bryan T Lin, Treasuer/president, as its authorized official.

NPPES Registry Identity

NPI1104830074
Entity TypeOrganization
Primary Taxonomy207ZP0102X
Legal Business NameINTERSCOPE PATHOLOGY MEDICAL GROUP INC
Location Address30700 RUSSELL RANCH RD SUITE 250, UNIT 235Westlake Village, CA 91362-5907
Mailing Address30700 Russell Ranch Rd Ste 250Westlake Village, CA 91362-9507 · (818) 992-7848 · Fax (818) 992-7748
Phone(818) 992-7848
Fax(818) 992-7748
Organization SubpartNo
Authorized OfficialBryan T LinTreasuer/president · (818) 992-7848
Enumeration DateJuly 28, 2006
Last NPPES UpdateJanuary 5, 20263 updates tracked since enumeration
NPPES CertifiedJanuary 5, 2026
✔ NPI 1104830074 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ZP0102X
License✔ Licensed in CA · 05D0700248
Definition
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
30700 RUSSELL RANCH RD SUITE 250, UNIT 235, Westlake Village, CA 91362
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Interscope Pathology Medical Group Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Interscope Pathology Medical Group Inc, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Bryan Lin, M.D. PHD
Pathology
NPI 1427077171
30700 RUSSELL RANCH RD STE 250
Westlake Village, CA 91362
(818) 992-7848
✔ PECOS✔ Accepts MedicareSame address
Igor Kozlov, M.D.
Pathology
NPI 1881629368
21114 VANOWEN ST
Canoga Park, CA 91303
(818) 992-7848
✔ PECOS✔ Accepts Medicare12 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 05D0700248

Interscope Pathology Medical Group · Westlake Village, CA
Expired · Sep 30, 2026
CLIA Number05D0700248
Laboratory TypeIndependent
Certificate Effective DateAugust 9, 2023
Certificate Expiration DateSeptember 30, 2026
Laboratory DirectorBryan T. Lin
Laboratory Phone(818) 992-7848
Laboratory LocationInterscope Pathology Medical Group30700 Russell Ranch Rd Suite 250 Room 235, Westlake Village, CA 91362
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Interscope Pathology Medical Group Inc's NPI number?

The NPI number for Interscope Pathology Medical Group Inc is 1104830074. It was assigned to this organization in the NPPES registry on July 28, 2006.

Where is Interscope Pathology Medical Group Inc located?

Interscope Pathology Medical Group Inc is located at 30700 Russell Ranch Rd Suite 250, Unit 235, Westlake Village, CA 91362. The listed phone number is (818) 992-7848.

What is Interscope Pathology Medical Group Inc's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

Is Interscope Pathology Medical Group Inc enrolled in Medicare?

Yes. Interscope Pathology Medical Group Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Interscope Pathology Medical Group Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Pathology, reassign their Medicare billing to Interscope Pathology Medical Group Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Interscope Pathology Medical Group Inc was last updated on January 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.