Provider Demographics
NPI:1528326709
Name:HOVASAPIAN, AIDA HAGOP (RPH)
Entity type:Individual
Prefix:MRS
First Name:AIDA
Middle Name:HAGOP
Last Name:HOVASAPIAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:459 W. BROADWAY
Mailing Address - Street 2:#4
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-1228
Mailing Address - Country:US
Mailing Address - Phone:818-548-6165
Mailing Address - Fax:818-548-7095
Practice Address - Street 1:459 W. BROADWAY
Practice Address - Street 2:#4
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-1228
Practice Address - Country:US
Practice Address - Phone:818-548-6165
Practice Address - Fax:818-548-7095
Is Sole Proprietor?:No
Enumeration Date:2012-04-25
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH47060183500000X
NV12219183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist