Healthcare Provider Details

I. General information

NPI: 1134587652
Provider Name (Legal Business Name): BOWMAN MEDICAL CENTER FOR TMS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2016
Last Update Date: 01/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9777 WILSHIRE BLVD STE 707
BEVERLY HILLS CA
90212-1907
US

IV. Provider business mailing address

9777 WILSHIRE BLVD STE 507
BEVERLY HILLS CA
90212-1905
US

V. Phone/Fax

Practice location:
  • Phone: 310-276-4003
  • Fax: 310-276-4073
Mailing address:
  • Phone: 310-276-4003
  • Fax: 310-276-4073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA73152
License Number StateCA

VIII. Authorized Official

Name: DR. PHILLIP BOWMAN
Title or Position: CEO
Credential: M.D.
Phone: 310-276-4003