Healthcare Provider Details

I. General information

NPI: 1801011085
Provider Name (Legal Business Name): ARSEN HOVANESYAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2007
Last Update Date: 05/07/2021
Certification Date: 05/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 HONOLULU AVE
MONTROSE CA
91020-1805
US

IV. Provider business mailing address

2525 HONOLULU AVE
MONTROSE CA
91020-1805
US

V. Phone/Fax

Practice location:
  • Phone: 818-484-8878
  • Fax: 818-659-7704
Mailing address:
  • Phone: 818-484-8878
  • Fax: 818-659-7704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA99380
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: