Individual
MR. JACOB R POGOSIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5242 SAN FERNANDO RD, GLENDALE, CA 91203-2439
(818) 265-0001
(818) 265-0008
Mailing address
5242 SAN FERNANDO RD, GLENDALE, CA 91203-2439
(818) 265-0001
(818) 265-0008
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
TG516
CA
291U00000X
Clinical Medical Laboratory
Primary
CLF333109
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CLF333109
CLIA
CA
Enumeration date
02/06/2007
Last updated
08/21/2007
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