Healthcare Provider Details

I. General information

NPI: 1689616153
Provider Name (Legal Business Name): PAUL G. HOVSEPIAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 07/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 E ADAMS AVE
ALHAMBRA CA
91801-4802
US

IV. Provider business mailing address

11 E ADAMS AVE
ALHAMBRA CA
91801-4802
US

V. Phone/Fax

Practice location:
  • Phone: 626-872-6215
  • Fax: 626-872-2855
Mailing address:
  • Phone: 626-872-6215
  • Fax: 626-872-2855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA401173
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: