Healthcare Provider Details

I. General information

NPI: 1801391990
Provider Name (Legal Business Name): MAX BOWMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2018
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 PARNASSUS AVE # S321
SAN FRANCISCO CA
94143-2205
US

IV. Provider business mailing address

400 PARNASSUS AVE # A633
SAN FRANCISCO CA
94143-2202
US

V. Phone/Fax

Practice location:
  • Phone: 801-824-5298
  • Fax:
Mailing address:
  • Phone: 415-885-7748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberA163544
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: