Healthcare Provider Details

I. General information

NPI: 1083539639
Provider Name (Legal Business Name): HOVEN REGENERATIVE MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14121 ERWIN ST SUITE 104
VAN NUYS CA
91401-2896
US

IV. Provider business mailing address

14121 ERWIN ST SUITE 104
VAN NUYS CA
91401-2896
US

V. Phone/Fax

Practice location:
  • Phone: 747-327-5434
  • Fax: 747-327-5408
Mailing address:
  • Phone: 747-327-5434
  • Fax: 747-327-5408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. HOVHANNES GHAZARYAN
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 747-327-5434