Provider Demographics
NPI:1821755414
Name:NANAR HOVASAPIAN OD CORPORATION
Entity Type:Organization
Organization Name:NANAR HOVASAPIAN OD CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANAR
Authorized Official - Middle Name:
Authorized Official - Last Name:HOVASAPIAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:818-631-7485
Mailing Address - Street 1:PO BOX 5861
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91221-5861
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1808 VERDUGO BLVD STE 103
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208-1482
Practice Address - Country:US
Practice Address - Phone:310-906-0393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty