Provider Demographics
NPI:1932624145
Name:MARTINYAN, POGOS
Entity Type:Individual
Prefix:MR
First Name:POGOS
Middle Name:
Last Name:MARTINYAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31344 VIA COLINAS STE 104
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-6853
Mailing Address - Country:US
Mailing Address - Phone:818-219-9690
Mailing Address - Fax:
Practice Address - Street 1:31344 VIA COLINAS STE 104
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-6853
Practice Address - Country:US
Practice Address - Phone:818-219-9690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACLF00347739207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine