Healthcare Provider Details

I. General information

NPI: 1659441475
Provider Name (Legal Business Name): BRIAN LOWE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 PARK TER FL 2
LOS ANGELES CA
90045-1543
US

IV. Provider business mailing address

14319 STARBUCK ST
WHITTIER CA
90605-2367
US

V. Phone/Fax

Practice location:
  • Phone: 310-665-7100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: