Healthcare Provider Details

I. General information

NPI: 1417836297
Provider Name (Legal Business Name): RADWA ZOWILA OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

292 S LA CIENEGA BLVD STE 250
BEVERLY HILLS CA
90211-3357
US

IV. Provider business mailing address

292 S LA CIENEGA BLVD STE 250
BEVERLY HILLS CA
90211-3357
US

V. Phone/Fax

Practice location:
  • Phone: 310-954-9614
  • Fax:
Mailing address:
  • Phone: 310-954-9614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number27784
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: