AFFILIATED PATHOLOGISTS MEDICAL GROUP, INC. - NPI 1730119553

Q: What is the provider's specialty?

The provider's specialty is Pathology with taxonomy code 207ZP0102X and a focus in Anatomic Pathology & Clinical Pathology.

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About Affiliated Pathologists Medical Group, Inc. NPPES

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

AFFILIATED PATHOLOGISTS MEDICAL GROUP, INC. (NPI 1730119553) is a healthcare organization registered as an anatomic pathology & clinical pathology in Rancho Dominguez, California and active in the NPI registry since July 2006. The organization holds a CLIA Certificate of Compliance certificate valid through July 31, 2026 and lists Stanette Kennebrew, Administrator, as its authorized official.

NPPES Registry Identity

NPI1730119553

Entity TypeOrganization

Primary Taxonomy207ZP0102X

Legal Business NameAFFILIATED PATHOLOGISTS MEDICAL GROUP, INC.

Location Address20001 S RANCHO WAYRancho Dominguez, CA 90220-6318

Mailing Address20001 S Rancho WayRancho Dominguez, CA 90220-6318 · (310) 225-3221 · Fax (310) 698-7040

Phone(310) 225-3221

Fax(310) 698-7040

Organization SubpartNo

Authorized OfficialStanette KennebrewAdministrator · (310) 225-3221

Enumeration DateJuly 4, 2006

Last NPPES UpdateMarch 14, 20252 updates tracked since enumeration

NPPES CertifiedMarch 14, 2025

✔ NPI 1730119553 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians

Taxonomy Code207ZP0102X

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.

20001 S RANCHO WAY, Rancho Dominguez, CA 90220

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Other Identifiers 10

MedicaidGR0082250CA

MedicaidGR0076820CA

MedicaidGR0023280CA

MedicaidGR0085330CA

MedicaidGR0085337CA

MedicaidGR0017680CA

MedicaidGR0055010CA

MedicaidGR0085336CA

MedicaidGR0085333CA

MedicaidGR0054410CA

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

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 05D2006397

Affiliated Pathologists Medical Group Inc · Rancho Dominguez, CA

Active · expires Jul 31, 2026

CLIA Number05D2006397

Laboratory TypeIndependent

Certificate Effective DateDecember 1, 2023

Certificate Expiration DateJuly 31, 2026

Laboratory DirectorDr. James B. Harris

Laboratory Phone(310) 225-3221

Laboratory LocationAffiliated Pathologists Medical Group Inc20001 S Rancho Way, Rancho Dominguez, CA 90220

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.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALESSANDRO DE VITO M.D.

Pathology (Anatomic Pathology & Clinical Pathology)