Healthcare Provider Details

I. General information

NPI: 1003075557
Provider Name (Legal Business Name): CAROLYN R TOWLER MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 12/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2218 GRAHAM AVE UNIT B
REDONDO BEACH CA
90278-2030
US

IV. Provider business mailing address

2218 GRAHAM AVE UNIT B
REDONDO BEACH CA
90278-2030
US

V. Phone/Fax

Practice location:
  • Phone: 310-493-7696
  • Fax: 310-370-0234
Mailing address:
  • Phone: 310-493-7696
  • Fax: 310-370-0234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: DR. CAROLYN ROSE TOWLER
Title or Position: PRESIDENT
Credential: MD
Phone: 310-493-7696