Leo Polosajian, Md, A Professional Medical Corporation | |
7640 Tampa Ave Suite 101 Reseda CA 91335-1735 | |
(818) 718-1600 | |
(818) 718-1920 |
Full Name | Leo Polosajian, Md, A Professional Medical Corporation |
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Speciality | Internal Medicine |
Location | 7640 Tampa Ave, Reseda, California |
Authorized Official Name and Position | Leo Polosajian (PRESIDENT) |
Authorized Official Contact | 8187181600 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Leo Polosajian, Md, A Professional Medical Corporation 4930 Balboa Blvd No 261278 Encino CA 91426-1278 Ph: (818) 718-1600 | Leo Polosajian, Md, A Professional Medical Corporation 7640 Tampa Ave Suite 101 Reseda CA 91335-1735 Ph: (818) 718-1600 |
NPI Number | 1912122631 |
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Provider Enumeration Date | 04/16/2007 |
Last Update Date | 09/12/2014 |
Medicare PECOS PAC ID | 7810080363 |
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Medicare Enrollment ID | O20070829000787 |
Identifier | Type | State | Issuer |
---|---|---|---|
1912122631 | NPI | - | NPPES |
1174664783 | Other | CA | PERSONAL NPI NUMBER |
A81080 | Other | CA | CA LICENSE NUMBER |
Provider Name | Leo Polosajian |
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Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1174664783 PECOS PAC ID: 9436050580 Enrollment ID: I20070829000769 |
Provider Name | Catherine Garganera-quinzon |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902253792 PECOS PAC ID: 3779857404 Enrollment ID: I20170919004108 |
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