Healthcare Provider Details

I. General information

NPI: 1477990760
Provider Name (Legal Business Name): MICHAEL THOMAS LOWENSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

9 FUNSTON AVE
SAN FRANCISCO CA
94129-1110
US

IV. Provider business mailing address

9 FUNSTON AVE
SAN FRANCISCO CA
94129-1110
US

V. Phone/Fax

Practice location:
  • Phone: 415-561-6773
  • Fax:
Mailing address:
  • Phone: 415-561-6773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License NumberG59574
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: