Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | A96283 | CA |
N | 208600000X | Surgeon | A96283 | CA |
N | 2086S0122X | Plastic and Reconstructive Surgery | A96283 | CA |
NPI | 1154502144 |
---|---|
Provider Name | Dr. Raffi V Hovsepian |
First Address | Newport Beach, CA 92660-8708 |
Second Address | Newport Beach, CA 92660-8708 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2007 |
Last Update Date | 12/05/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A96283 | STATE LICENSE (01) | CA |