MEDICARE: HOVSEPYAN OD PROF. CORP.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1043165822
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOVSEPYAN OD PROF. CORP.

Provider Business Mailing Address
First Line	:	3768 E COLORADO BLVD STE B
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91107-3972
Country	:	US
Telephone Number	:	626-345-5279
Fax Number	:	626-345-5293

Provider Business Practice Location Address
First Line	:	3768 E COLORADO BLVD STE B
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91107-3972
Country	:	US
Telephone Number	:	626-421-8035
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. JIVAN HOVSEPYAN
Credential	:	OD
Telephone Number	:	626-421-8035

Provider Enumeration Date	:	02/26/2026
Last Update Date	:	04/07/2026

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