| Leo Polosajian Md A Professional Med Corp | |
|
7640 Tampa Ave Ste 101 Reseda CA 91335-1713 | |
| (818) 718-1600 | |
| (818) 718-1920 |
| Full Name | Leo Polosajian Md A Professional Med Corp |
|---|---|
| Speciality | Internal Medicine |
| Location | 7640 Tampa Ave Ste 101, Reseda, California |
| Authorized Official Name and Position | Leo Polosajian (CEO) |
| Authorized Official Contact | 8187181600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Leo Polosajian Md A Professional Med Corp 4930 Balboa Blvd Unit 261278 Encino CA 91426-7062 Ph: (818) 718-1600 | Leo Polosajian Md A Professional Med Corp 7640 Tampa Ave Ste 101 Reseda CA 91335-1713 Ph: (818) 718-1600 |
| NPI Number | 1912122631 |
|---|---|
| Provider Enumeration Date | 04/16/2007 |
| Last Update Date | 06/19/2026 |
| Medicare PECOS PAC ID | 7810080363 |
|---|---|
| Medicare Enrollment ID | O20070829000787 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912122631 | NPI | - | NPPES |
| 1174664783 | Other | CA | PERSONAL NPI NUMBER |
| A81080 | Other | CA | CA LICENSE NUMBER |
| Provider Name | Leo Polosajian |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1174664783 PECOS PAC ID: 9436050580 Enrollment ID: I20070829000769 |
| Provider Name | Catherine Garganera-quinzon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902253792 PECOS PAC ID: 3779857404 Enrollment ID: I20170919004108 |
| Provider Name | Johnathon Curtis Rollo |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1104185644 PECOS PAC ID: 9638448376 Enrollment ID: I20210721003793 |
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