=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598866980
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOVE CENTER FOR FACIAL PLASTIC SURGERY, AMC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/26/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 41715 WINCHESTER RD SUITE 205
-----------------------------------------------------
City | TEMECULA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92590-4808
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-719-2950
-----------------------------------------------------
Fax | 951-719-2951
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 41715 WINCHESTER RD SUITE 205
-----------------------------------------------------
City | TEMECULA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92590-4808
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-719-2950
-----------------------------------------------------
Fax | 951-719-2951
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN/OWNER
-----------------------------------------------------
Name | DR. CHRISTOPHER RANDALL HOVE
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 951-719-2950
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | A75246
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------