Healthcare Provider Details

I. General information

NPI: 1407054182
Provider Name (Legal Business Name): ARNAUD F BEWLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2007
Last Update Date: 10/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2521 STOCKTON BLVD SUITE 7200
SACRAMENTO CA
95817-2207
US

IV. Provider business mailing address

2521 STOCKTON BLVD SUITE 7200
SACRAMENTO CA
95817-2207
US

V. Phone/Fax

Practice location:
  • Phone: 215-593-0606
  • Fax:
Mailing address:
  • Phone: 215-593-0606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberA126121
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: