| J O Medical Professional Corporation | |
|
13739 Riveside Drive Unit B Sherman Oaks CA 91423-2417 | |
| (818) 292-8000 | |
| (818) 507-6414 |
| Full Name | J O Medical Professional Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 13739 Riveside Drive, Sherman Oaks, California |
| Authorized Official Name and Position | Janna Oganessian (CEO) |
| Authorized Official Contact | 8182928000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| J O Medical Professional Corporation 1325 East Windsor Rd 4 Glendale CA 91205-6277 Ph: (818) 292-8000 | J O Medical Professional Corporation 13739 Riveside Drive Unit B Sherman Oaks CA 91423-2417 Ph: (818) 292-8000 |
| NPI Number | 1568636009 |
|---|---|
| Provider Enumeration Date | 04/16/2008 |
| Last Update Date | 04/16/2008 |
| Medicare PECOS PAC ID | 8426127978 |
|---|---|
| Medicare Enrollment ID | O20080523000158 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568636009 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A79854 (California) | Primary |
| Provider Name | Janna Oganessian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801820832 PECOS PAC ID: 3072682525 Enrollment ID: I20080523000145 |
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