Provider Demographics
NPI:1801820832
Name:OGANESSIAN, JANNA (MD)
Entity Type:Individual
Prefix:DR
First Name:JANNA
Middle Name:
Last Name:OGANESSIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1325 E WINDSOR RD
Mailing Address - Street 2:# 4
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-2677
Mailing Address - Country:US
Mailing Address - Phone:818-425-9947
Mailing Address - Fax:818-758-8286
Practice Address - Street 1:18607 VENTURA BLVD
Practice Address - Street 2:# 101
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-4159
Practice Address - Country:US
Practice Address - Phone:818-758-8282
Practice Address - Fax:818-758-8286
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA79854207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH91834Medicare UPIN