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General NPI Number Information
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NPI Number | 1851693758
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Entity Type | Organization
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Legal Business Name | MICHAEL M HOVSEPIAN MD A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 11/27/2010
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Last Update Date | 09/04/2015
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Provider Practice Location Address
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Address Line | 1239 COACH HOUSE CT
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City | FULLERTON
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State | CA
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Zip | 92831-1052
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Country | US
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Telephone | 818-281-8588
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Fax |
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Provider Business Mailing Address
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Address Line | 1239 COACH HOUSE CT
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City | FULLERTON
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State | CA
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Zip | 92831-1052
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Country | US
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Telephone | 818-281-8588
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL M HOVSEPIAN
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Credential | M.D.
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Telephone | 818-281-8588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | G85250
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License Number State | CA
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