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Organization
LEO POLOSAJIAN MD A PROFESSIONAL MED CORP
Active
Organization
LEO POLOSAJIAN MD A PROFESSIONAL MED CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEO POLOSAJIAN MD (CEO)
(818) 718-1600
Entity
Organization
Contact information
Practice address
7640 TAMPA AVE STE 101, RESEDA, CA 91335-1713
(818) 718-1600
(818) 718-1920
Mailing address
4930 BALBOA BLVD UNIT 261278, ENCINO, CA 91426-7062
(818) 718-1600
(818) 718-1920
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
—
NULL
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174664783
PERSONAL NPI NUMBER
CA
01
—
A81080
CA LICENSE NUMBER
CA
Enumeration date
04/16/2007
Last updated
06/19/2026
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