Organization
GERALD M. POHOST, MD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD M. POHOST MD (OWNER)
(818) 409-3501
Entity
Organization
Contact information
Practice address
1505 WILSON TER, SUITE 150, GLENDALE, CA 91206-4071
(818) 409-3501
(818) 956-7680
Mailing address
2200 N MAYFAIR RD, SUITE 200, WAUWATOSA, WI 53226-2252
(414) 258-9511
(414) 607-3946
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DS3096
RR MEDICARE
CA
01
—
ZZZ68624Y
BLUE SHIELD
CA
Enumeration date
09/12/2011
Last updated
05/24/2012
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