Jacklin Poladian, M.D., INC.
Clinic/Center, Primary Care in Pasadena, CA. Organization (NPI-2).
NPI number1598033920
StatusActive
Last updated in NPPESOct 27, 2023
Details
- NPI
- 1598033920
- Entity type
- Organization (NPI-2)
- Legal business name
- Jacklin Poladian, M.D., INC.
- Organization subpart
- No
- Enumeration date
- Dec 13, 2011
- Certification date
- Oct 27, 2023
- Last updated
- Oct 27, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | A110327 | CA | Yes |
Practice location
800 Fairmount Ave Ste 420Pasadena, CA 91105-3154
Phone 626-200-4500 · Fax 626-795-0704
Mailing address
301 S Fair Oaks AveSuite 403
Pasadena, CA 91105-2561
Phone 626-200-4500 · Fax 626-795-0704
Authorized official
Jacklin Poladian
Chief Executive Officer
6262004500
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