Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | A54708 | CA |
NPI | 1083798284 |
---|---|
Provider Name | Karol Bowens |
First Address | Lynwood, CA 90262-3512 |
Second Address | Lynwood, CA 90262-3512 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 24/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A547080 | (05) | CA |