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General NPI Number Information
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NPI Number | 1659365526
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Entity Type | Individual
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Provider Name | HOWARD WAYNE FELLOWS M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/07/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 11480 BROOKSHIRE AVE STE 309
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City | DOWNEY
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State | CA
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Zip | 90241-5025
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Country | US
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Telephone | 562-869-1201
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Fax | 562-869-1281
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Provider Business Mailing Address
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Address Line | 11480 BROOKSHIRE AVE STE 309
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City | DOWNEY
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State | CA
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Zip | 90241-5025
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Country | US
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Telephone | 562-869-1201
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Fax | 562-869-1281
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 39213
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | G88376
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License Number State | CA
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