MEDICARE: MS. MEGAN ELIZABETH PANCOST MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	35806	CA

General Provider Information

NPI Number	:	1194666248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MEGAN ELIZABETH PANCOST MS

Provider Business Mailing Address
First Line	:	223 N JACKSON ST
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91206-4380
Country	:	US
Telephone Number	:	818-241-3111
Fax Number	:

Provider Business Practice Location Address
First Line	:	744 E DORAN ST
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91206-2422
Country	:	US
Telephone Number	:	818-241-2164
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2026
Last Update Date	:	04/02/2026

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