JACOB POULOSE (NPI# 1578723508) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578723508 |
| Entity Type | Individual |
| Full Name | JACOB POULOSE |
| Credential | MD. |
| Practice Address |
8349 Reseda Blvd Suite G Northridge CA 91324-4622 |
| Practice Telephone | 8188865827 |
| Practice Fax Number | 8187759351 |
| Mailing Telephone | 8188865827 |
| Mailing Fax Number | 8187759351 |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2015-03-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | A113557 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A1135570 | 05 |
| Street Address |
8349 RESEDA BLVD SUITE G |
| City | NORTHRIDGE |
| State | CA |
| Zip Code | 91324-4622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568482461 | Kiran P Dua | General Practice | 8349 Reseda Blvd, Suite G, Northridge, CA 91324-5914 | 2006-07-20 |
| 1366895492 | Jewel Physical Therapy Inc | Physical Therapist | 8349 Reseda Blvd, Unit F, Northridge, CA 91324-4622 | 2016-07-13 |
| 1427204510 | Kiran B Dua Md | Clinic/Center | 8349 Reseda Blvd, Suite G, Northridge, CA 91324-4622 | 2008-08-08 |
| 1619162716 | Shahriar S Rad | Chiropractor | 8349 Reseda Blvd, Suite A, Northridge, CA 91324-4622 | 2007-09-11 |
| 1215149026 | Sohan L. Dua M.d. | Specialist | 8349 Reseda Blvd, Suite G, Northridge, CA 91324-4622 | 2007-05-04 |
| 1083836803 | Rahil Khan Md, Inc. | General Practice | 8349 Reseda Blvd, Northridge, CA 91324-4622 | 2007-05-02 |
| 1447470554 | Mahfuzur Rahman | Internal Medicine | 8349 Reseda Blvd, Suite G, Northridge, CA 91324-4622 | 2007-04-30 |
| 1174545693 | Sohan L Dua | Internal Medicine | 8349 Reseda Blvd, Suite G, Northridge, CA 91324-5914 | 2006-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649803461 | Endeavor Recovery LLC | Clinic/Center | 8537 Yolanda Ave, Northridge, CA 91324 | 2020-02-20 |
| 1780227769 | Drs Concepts, Incorporated | Clinic/Center | 9335 Reseda Blvd. Suite 102, Northridge, CA 91324 | 2019-10-23 |
| 1023674421 | Expo Diagnostics, Inc. | Clinic/Center | 8619 Receda Blvd., Northridge, CA 91324 | 2019-05-13 |
| 1235601444 | Grace Peprah | Marriage & Family Therapist | 19037 Community Street, Northridge, CA 91324 | 2018-12-28 |
| 1336635531 | Kristel Fortuny Bushner | Specialist/Technologist | 9555 Reseda Blvd, 309, Northridge, CA 91324 | 2018-07-11 |
| 1710474358 | Rara Enterprises Inc | Pharmacy | 19331 Business Center Dr., Ste. 100, Northridge, CA 91324 | 2018-04-19 |
| 1205343670 | Mariana Nicol Valdez Castro | Behavior Technician | 9335 Reseda Blvd # 101, Northridge, CA 91324 | 2018-01-05 |
| 1033655220 | Benyaminy and Kashani Dds,inc. | Clinic/Center | 8954 Reseda Blvd #100, Northridge, CA 91324 | 2017-01-11 |
| 1366809915 | Tia Brisco | Counselor | 9700 Reseda Blvd Ste 208, Northridge, CA 91324 | 2016-01-26 |
| 1053780189 | Saloni Kadakia | Student in an Organized Health Care Education/Training Program | Ucla Olive View, 14445 Olive View Dr, Sylmar, Ca 91342, CA 91324 | 2015-09-18 |
| Find all providers in zip 91324 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740669688 | Nkolika Christine Akpati | Internal Medicine | 18207 Chase St, Northridge, CA 91325-3731 | 2015-05-26 |
| 1730516303 | Siamak Etehad, Md, Inc. A Medical Corporation | Internal Medicine | 17075 Devonshire St Ste 100, Northridge, CA 91325-5405 | 2013-09-27 |
| 1760814917 | William Y Josephson, Md, Inc | Internal Medicine | 17075 Devonshire St Ste 100a, Northridge, CA 91325-5405 | 2013-07-30 |
| 1326481698 | Ali Ozhand | Internal Medicine | 8510 Balboa Blvd Ste 200, Northridge, CA 91325 | 2013-04-16 |
| 1932435047 | Southern California Physician Consultants Solutions, PC | Internal Medicine | 18300 Roscoe Blvd., Northridge, CA 91328 | 2009-10-23 |
| 1487802674 | Tam Thanh Huynh | Internal Medicine | 18638 Liggett St, Northridge, CA 91324-2922 | 2008-09-03 |
| 1669501409 | Alan Darush, M.d., A Professional Corporation | Internal Medicine | 8540 Reseda Blvd # 103, Northridge, CA 91324-4628 | 2007-03-05 |
| 1982752465 | Mohammed Sharjeel Farooqui | Internal Medicine | 18433 Roscoe Blvd Ste 202, Northridge, CA 91325-4134 | 2007-01-08 |
| 1376647651 | William Y Josephson | Internal Medicine | 17075 Devonshire, #100a, Northridge, CA 91325 | 2006-09-08 |
| 1093723595 | Buttelman Medical Corporation | Internal Medicine | 17075 Devonshire St Ste 209, Northridge, CA 91325-5411 | 2006-08-03 |
| Find all providers in NORTHRIDGE | ||||
| City | NORTHRIDGE |
| Zip Code | 91324 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.