Provider Demographics
NPI:1043282908
Name:POCOCK, THOMAS YARGER (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:YARGER
Last Name:POCOCK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1809 VERDUGO BLVD
Mailing Address - Street 2:#200
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208
Mailing Address - Country:US
Mailing Address - Phone:818-790-6700
Mailing Address - Fax:818-790-2816
Practice Address - Street 1:1809 VERDUGO BLVD
Practice Address - Street 2:#200
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208
Practice Address - Country:US
Practice Address - Phone:818-790-6700
Practice Address - Fax:818-790-2816
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG34425207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A45925Medicare UPIN