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General NPI Number Information
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NPI Number | 1336777366
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Entity Type | Individual
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Provider Name | HOVSEP OHAN MD
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Gender | Male
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Dates
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Enumeration Date | 03/27/2020
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 4301 N STAR WAY
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City | MODESTO
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State | CA
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Zip | 95356-9262
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Country | US
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Telephone | 209-577-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 622 S COLUMBUS AVE
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City | GLENDALE
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State | CA
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Zip | 91204-1920
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Country | US
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Telephone | 184-147-2318
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number | 4351046256
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | A195285
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License Number State | CA
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