Healthcare Provider Details

I. General information

NPI: 1750525929
Provider Name (Legal Business Name): RAFFI V HOVSEPIAN MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2009
Last Update Date: 06/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 AVOCADO AVE STE 810
NEWPORT BEACH CA
92660-8708
US

IV. Provider business mailing address

1401 AVOCADO AVE STE 810
NEWPORT BEACH CA
92660-8708
US

V. Phone/Fax

Practice location:
  • Phone: 949-760-5047
  • Fax: 949-760-0978
Mailing address:
  • Phone: 949-760-5047
  • Fax: 949-760-0978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RAFFI V HOVSEPIAN
Title or Position: OWNER
Credential: M.D.
Phone: 949-325-1217