Healthcare Provider Details

I. General information

NPI: 1023467339
Provider Name (Legal Business Name): PHILIP BENJAMIN CAWKWELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2016
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 QUARRY RD
PALO ALTO CA
94304-1419
US

IV. Provider business mailing address

15732 LOS GATOS BLVD # 5100
LOS GATOS CA
95032-2504
US

V. Phone/Fax

Practice location:
  • Phone: 650-564-4283
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA161153
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: