Healthcare Provider Details

I. General information

NPI: 1467914317
Provider Name (Legal Business Name): SEVAK HOVAGIMYAN PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2019
Last Update Date: 04/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13677 FOOTHILL BLVD #B
SYLMAR CA
91342
US

IV. Provider business mailing address

13677 FOOTHILL BLVD #B
SYLMAR CA
91342
US

V. Phone/Fax

Practice location:
  • Phone: 818-698-4053
  • Fax: 818-698-4046
Mailing address:
  • Phone: 818-698-4053
  • Fax: 818-698-4046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number75427
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: