Healthcare Provider Details

I. General information

NPI: 1861691479
Provider Name (Legal Business Name): STACEY MICHELLE LOWEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2007
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 TRIUNFO CANYON RD STE 120
WESTLAKE VILLAGE CA
91361-2525
US

IV. Provider business mailing address

5767 W CENTURY BLVD STE 400
LOS ANGELES CA
90045-5631
US

V. Phone/Fax

Practice location:
  • Phone: 805-557-7187
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA106826
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: