Individual
AVA HACOPIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1620 GRAEBER STREET , SUITE 9, 163RD MDG MARCH AIR RESERVE BASE/, MORENO VALLEY, CA 92518
(916) 854-3000
Mailing address
1620 GRAEBER STREET , SUITE 9, 163RD MDG MARCH AIR RESERVE BASE/, MORENO VALLEY, CA 92518
(916) 854-3000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
11784
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A632960
—
CA
Enumeration date
05/20/2006
Last updated
12/31/2019
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