Provider Demographics
NPI:1851910665
Name:GHAZARYAN, HOVHANNES (MD)
Entity type:Individual
Prefix:DR
First Name:HOVHANNES
Middle Name:
Last Name:GHAZARYAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HOVHANNES
Other - Middle Name:
Other - Last Name:GHAZARYAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:100 N STATE COLLEGE BLVD STE H
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92831-4236
Mailing Address - Country:US
Mailing Address - Phone:714-824-6565
Mailing Address - Fax:714-930-7926
Practice Address - Street 1:100 N STATE COLLEGE BLVD STE H
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-4236
Practice Address - Country:US
Practice Address - Phone:714-824-6565
Practice Address - Fax:714-930-7926
Is Sole Proprietor?:No
Enumeration Date:2020-04-11
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA184528208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine