| Jacklin Poladian, M.d., Inc. | |
|
800 Fairmount Ave Ste 420 Pasadena CA 91105-3154 | |
| (626) 200-4500 | |
| (626) 795-0704 |
| Full Name | Jacklin Poladian, M.d., Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 800 Fairmount Ave Ste 420, Pasadena, California |
| Authorized Official Name and Position | Jacklin Poladian (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6262004500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacklin Poladian, M.d., Inc. 301 S Fair Oaks Ave Suite 403 Pasadena CA 91105-2561 Ph: (626) 200-4500 | Jacklin Poladian, M.d., Inc. 800 Fairmount Ave Ste 420 Pasadena CA 91105-3154 Ph: (626) 200-4500 |
| NPI Number | 1598033920 |
|---|---|
| Provider Enumeration Date | 12/13/2011 |
| Last Update Date | 10/27/2023 |
| Medicare PECOS PAC ID | 0446418222 |
|---|---|
| Medicare Enrollment ID | O20120224000504 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598033920 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A110327 (California) | Primary |
| Provider Name | Jacklin Poladian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629239892 PECOS PAC ID: 9931367794 Enrollment ID: I20120224000309 |
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