Provider Demographics
NPI:1801011085
Name:HOVANESYAN, ARSEN (MD)
Entity Type:Individual
Prefix:
First Name:ARSEN
Middle Name:
Last Name:HOVANESYAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 HONOLULU AVE
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CA
Mailing Address - Zip Code:91020-1805
Mailing Address - Country:US
Mailing Address - Phone:818-484-8878
Mailing Address - Fax:818-659-7704
Practice Address - Street 1:2525 HONOLULU AVE
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CA
Practice Address - Zip Code:91020-1805
Practice Address - Country:US
Practice Address - Phone:818-484-8878
Practice Address - Fax:818-659-7704
Is Sole Proprietor?:No
Enumeration Date:2007-04-14
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA99380207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFH948ZMedicare PIN