Healthcare Provider Details

I. General information

NPI: 1982089223
Provider Name (Legal Business Name): JAMES B FOWLER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2015
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39000 BOB HOPE DR
RANCHO MIRAGE CA
92270-3221
US

IV. Provider business mailing address

26520 CACTUS AVE STE A2006
MORENO VALLEY CA
92555-3927
US

V. Phone/Fax

Practice location:
  • Phone: 760-610-8781
  • Fax: 760-507-8316
Mailing address:
  • Phone: 951-486-4460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number20A16151
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number073193
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: