Provider Demographics
NPI:1265564496
Name:J.H.S. MEDICAL CENTER, INC.
Entity type:Organization
Organization Name:J.H.S. MEDICAL CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SARKISAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:818-240-9911
Mailing Address - Street 1:1030 S GLENDALE AVE STE 404
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-2866
Mailing Address - Country:US
Mailing Address - Phone:818-240-9911
Mailing Address - Fax:818-240-9939
Practice Address - Street 1:1030 S GLENDALE AVE STE 404
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-2866
Practice Address - Country:US
Practice Address - Phone:818-240-9911
Practice Address - Fax:818-240-9939
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:J.H.S. MEDICAL CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-12
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43433207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FC726ZMedicare PIN
CAW15394Medicare PIN