Unknown Individual – Anatomic Pathology & Clinical Pathology Physician, NPI 1912964552

Unknown Individual is a healthcare provider. based in Long beach, California. specializing in Anatomic Pathology & Clinical Pathology Physician. They hold a License No. G78865 (CA). The NPI Number for Unknown Individual is 1912964552

Main info

Organization
Inactive
35 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1912964552
Phone
(562) 933-0829
Address
2801 ATLANTIC AVE
Deactivation Date
11 January 2023

Doctor Profile

Medical School Name
UNIVERSITY OF CALIFORNIA, SAN DIEGO SCHOOL OF MEDICINE
Secondary Phone
5629330716
Graduation Year
1991 (35 years ago)
PAC ID
7315990256
Group Practice PAC ID
8426001363
Professional Enrollment ID
I20060825000256
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Long Beach Memorial Hospital, 2801, Atlantic Avenue, Willowville, Long Beach, Los Angeles County, California, 90806, United States

    DEPARTMANT OF PATHOLOGY

    LONG BEACH, CA 908061737

    Phone: (562) 933-0829

    Fax: (562) 933-0791

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 90806)

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Provider's Procedures

Unknown Individual performs procedures in Anatomic Pathology & Clinical Pathology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PATHOLOGYCA88304Pathology examination of tissue using a microscope, moderately low complexity3128

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8426001363View full group profile
NameSpecialtyState
P A T H O L O G YCA
-CA
-CA
P A T H O L O G YCO
P A T H O L O G YCA
P A T H O L O G YCA
P A T H O L O G YCA
P A T H O L O G YCA
P A T H O L O G YCA
P A T H O L O G YCA

Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1912964552.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Anatomic Pathology & Clinical Pathology Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Long Beach?
Unknown Individual currently maps to Long Beach, California in this extract.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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Unknown Individual

Anatomic Pathology & Clinical Pathology Physician
VA Long Beach Healthcare, 5901, East 7th Street, Long Beach, Los Angeles County, California, 90822, United States
NPI: 1144324187