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General NPI Number Information
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NPI Number | 1447904800
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Entity Type | Individual
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Provider Name | KATHRYN FOWLER DC
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Gender | Female
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Dates
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Enumeration Date | 02/04/2022
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Last Update Date | 02/04/2022
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Provider Practice Location Address
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Address Line | 6221 WILSHIRE BLVD STE 518
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City | LOS ANGELES
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State | CA
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Zip | 90048-5223
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Country | US
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Telephone | 323-549-0070
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Fax |
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Provider Business Mailing Address
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Address Line | 420 SIERRA ST APT 8
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City | EL SEGUNDO
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State | CA
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Zip | 90245-4077
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Country | US
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Telephone | 480-459-8044
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NP0017X
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Taxonomy Name | Pediatric Chiropractor
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License Number | 36260
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 36260
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License Number State | CA
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