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: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2975 SYCAMORE DR
SIMI VALLEY CA
93065-1201
US
IV. Provider business mailing address
1825 N LAS PALMAS AVE APT 438
LOS ANGELES CA
90028-4552
US
V. Phone/Fax
- Phone: 805-955-6000
- Fax:
- Phone: 818-397-2201
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | A187440 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | PTL2985 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: