Healthcare Provider Details

I. General information

NPI: 1568454866
Provider Name (Legal Business Name): ERIC BOWEN CALL NP
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/22/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 S BASCOM AVE LABOR & DELIVERY
SAN JOSE CA
95128-2604
US

IV. Provider business mailing address

PO BOX 248 1120 FOREST WAY
BROOKDALE CA
95007-0248
US

V. Phone/Fax

Practice location:
  • Phone: 408-885-6400
  • Fax: 408-885-6454
Mailing address:
  • Phone: 831-338-7167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number400787
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: