Healthcare Provider Details

I. General information

NPI: 1194666248
Provider Name (Legal Business Name): MEGAN ELIZABETH PANCOST MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

744 E DORAN ST
GLENDALE CA
91206-2422
US

IV. Provider business mailing address

223 N JACKSON ST
GLENDALE CA
91206-4380
US

V. Phone/Fax

Practice location:
  • Phone: 818-241-2164
  • Fax:
Mailing address:
  • Phone: 818-241-3111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number35806
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: