Provider Demographics
NPI:1114102993
Name:TER-POGHOSYAN, ZARINE (MD)
Entity Type:Individual
Prefix:DR
First Name:ZARINE
Middle Name:
Last Name:TER-POGHOSYAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12507 VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-3135
Mailing Address - Country:US
Mailing Address - Phone:818-454-0442
Mailing Address - Fax:818-782-5523
Practice Address - Street 1:303 S GLENOAKS BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1319
Practice Address - Country:US
Practice Address - Phone:818-842-8400
Practice Address - Fax:818-842-8487
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-30
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA101387207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine