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Individual
DR. BRIAN REZA POUSTINCHIAN
Active
Individual
DR. BRIAN REZA POUSTINCHIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036131483
IL
207R00000X
Internal Medicine Physician
125058545
IL
208M00000X
Hospitalist Physician
Primary
036.131483
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036131483
—
IL
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
206147241
MEDICARE PTAN (INDIVIDUAL)
IL
01
—
CA4748
MEDICARE RAILROAD PTAN (GROUP)
IL
01
—
P01248045
MEDICARE RAILROAD PTAN (INDIVIDUAL)
IL
Enumeration date
06/16/2010
Last updated
03/17/2018
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