Healthcare Provider Details
I. General information
NPI: 1598866980
Provider Name (Legal Business Name): HOVE CENTER FOR FACIAL PLASTIC SURGERY, AMC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
41715 WINCHESTER RD SUITE 205
TEMECULA CA
92590-4808
US
IV. Provider business mailing address
41715 WINCHESTER RD SUITE 205
TEMECULA CA
92590-4808
US
V. Phone/Fax
- Phone: 951-719-2950
- Fax: 951-719-2951
- Phone: 951-719-2950
- Fax: 951-719-2951
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | A75246 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
CHRISTOPHER
RANDALL
HOVE
Title or Position: PHYSICIAN/OWNER
Credential: M.D.
Phone: 951-719-2950