Individual
ANDRE VOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 HOAG DR, RADIOLOGY DEPT, NEWPORT BEACH, CA 92663-4162
(949) 764-6876
(949) 764-6874
Mailing address
PO BOX 749226, LOS ANGELES, CA 90074-9226
(949) 263-8620
(949) 263-1639
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A62060
CA
207RP1001X
Pulmonary Disease Physician
A62060
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A620600
BLUE SHIELD OF CA
CA
05
—
00A620600
—
CA
Enumeration date
06/08/2006
Last updated
02/09/2009
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