Healthcare Provider Details

I. General information

NPI: 1366071052
Provider Name (Legal Business Name): AREG HOVSEPYAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2020
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1812 VERDUGO BLVD
GLENDALE CA
91208-1407
US

IV. Provider business mailing address

PO BOX 597
MONTROSE CA
91021-0597
US

V. Phone/Fax

Practice location:
  • Phone: 818-790-7100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberPTL2985
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA187440
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: