Healthcare Provider Details

I. General information

NPI: 1497996185
Provider Name (Legal Business Name): DAVID BOWEN AU.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2009
Last Update Date: 03/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 BULLARD AVE STE 101
CLOVIS CA
93612-1054
US

IV. Provider business mailing address

420 BULLARD AVE STE 101
CLOVIS CA
93612-1054
US

V. Phone/Fax

Practice location:
  • Phone: 559-299-3566
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU2659
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: