Healthcare Provider Details

I. General information

NPI: 1154024735
Provider Name (Legal Business Name): HOVSEP STAMBULYAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2023
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 S GREEN VALLEY PKWY STE 100
HENDERSON NV
89052-0434
US

IV. Provider business mailing address

670 S GREEN VALLEY PKWY STE 100
HENDERSON NV
89052-0434
US

V. Phone/Fax

Practice location:
  • Phone: 725-262-4244
  • Fax: 725-745-6506
Mailing address:
  • Phone: 725-262-4244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number28392
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: