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NPI Code Detail

MEDICARE: MR. DENNIS COWAN PAC

MEDICARE: MR. DENNIS COWAN PAC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantPA11692CA

General Provider Information

NPI Number : 1477696177
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DENNIS COWAN PAC
Provider Business Mailing Address
First Line : 6650 RESEDA BLVD 101A
Second Line :
City : RESEDA
State : CA
Zip : 91335-8400
Country : US
Telephone Number : 818-708-7668
Fax Number : 818-708-9668
Provider Business Practice Location Address
First Line : 18646 OXNARD ST
Second Line :
City : TARZANA
State : CA
Zip : 91356-1411
Country : US
Telephone Number : 818-996-1051
Fax Number : 818-996-9338
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2007
Last Update Date : 09/22/2015

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Directions to “ MR. DENNIS COWAN PAC” Practice Location

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