LONG BEACH MEMORIAL PATHOLOGY MEDICAL GROUP, INC.
NPI 1942257191
Pathology - Anatomic Pathology & Clinical Pathology in Long Beach, CA

Q: What is Long Beach Memorial 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.

Active since May 30, 2006

2801 ATLANTIC AVE, DEPARTMENT OF PATHOLOGY, LONG BEACH, CA 90806(562) 933-0717(562) 933-0791 Get Directions Write a Review

NPPES record last updated: December 3, 2014. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Long Beach Memorial Pathology Medical Group, Inc. NPPES

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

LONG BEACH MEMORIAL PATHOLOGY MEDICAL GROUP, INC. (NPI 1942257191) is a healthcare organization registered as an anatomic pathology & clinical pathology in Long Beach, California and active in the NPI registry since May 2006. The organization lists Lisa Shane, Vice Pres. Treasurer, as its authorized official.

NPPES Registry Identity

NPI1942257191

Entity TypeOrganization

Primary Taxonomy207ZP0102X

Legal Business NameLONG BEACH MEMORIAL PATHOLOGY MEDICAL GROUP, INC.

Location Address2801 ATLANTIC AVE, DEPARTMENT OF PATHOLOGYLong Beach, CA 90806-1701

Mailing Address2801 Atlantic Ave, Department Of PathologyLong Beach, CA 90806-1701 · (562) 933-0717 · Fax (562) 933-0791

Phone(562) 933-0717

Fax(562) 933-0791

Organization SubpartNo

Authorized OfficialLisa ShaneVice Pres. Treasurer · (562) 933-0713

Enumeration DateMay 30, 2006

Last NPPES UpdateDecember 3, 2014

✔ NPI 1942257191 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.

2801 ATLANTIC AVE, Long Beach, CA 90806

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Other Identifiers 5

Medicare PINHW8095ACA

OtherZZZ96712ZCA · Blue Shield

MedicaidGR0049700CA

OtherZZZ05043ZCA · Blue Shield

Medicare PINHW8095CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

Medicare Revalidation Due Date

Revalidation due by October 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateCaliforniaEnrollment IDO20050302000982Non-DME Part B · Clinic/Group PracticeDue dateOctober 31, 2026

Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 12 clinicians reassign Medicare billing to Long Beach Memorial Pathology Medical Group, Inc., which bills Medicare for the services they deliver. Of these, 7 practice at this address and 8 within 10 miles. They are listed nearest first.

Clinicians, nearest first (12)

Wissam Dahoud, M.D.

Pathology

NPI 1932587649

2801 ATLANTIC AVE
Long Beach, CA 90806

(562) 933-0716