Healthcare Provider Details

I. General information

NPI: 1447475256
Provider Name (Legal Business Name): BOWEN CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 12/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11110 ARTESIA BLVD STE. G
CERRITOS CA
90703-2546
US

IV. Provider business mailing address

11110 ARTESIA BLVD STE. G
CERRITOS CA
90703-2546
US

V. Phone/Fax

Practice location:
  • Phone: 562-402-4848
  • Fax: 562-402-0258
Mailing address:
  • Phone: 562-402-4848
  • Fax: 562-402-0258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC15141
License Number StateCA

VIII. Authorized Official

Name: DR. MICHAEL JAMES BOWEN
Title or Position: PRESIDENT
Credential: DC
Phone: 562-402-4848