Healthcare Provider Details

I. General information

NPI: 1558298794
Provider Name (Legal Business Name): DOVEINCHI OP CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21054 SHERMAN WAY STE 340
CANOGA PARK CA
91303-4517
US

IV. Provider business mailing address

21054 SHERMAN WAY STE 340
CANOGA PARK CA
91303-4517
US

V. Phone/Fax

Practice location:
  • Phone: 747-270-3408
  • Fax:
Mailing address:
  • Phone: 747-270-3408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. MANVEL SMBATYAN
Title or Position: CEO
Credential:
Phone: 747-270-9408