Individual
JILLIAN A. POLONCHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
1520 SAN PABLO ST STE 3000, LOS ANGELES, CA 90033-5315
(323) 442-5710
Mailing address
6201 GREENLEIGH AVE FL 2, MIDDLE RIVER, MD 21220-2004
(410) 933-2704
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
R256994
MD
363LA2100X
Acute Care Nurse Practitioner
NP95012773
CA
Other
Enumeration date
09/12/2019
Last updated
10/24/2024
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