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General NPI Number Information
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NPI Number | 1760465728
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Entity Type | Individual
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Provider Name | BENJAMIN F COWAN MD
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Gender | Male
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Dates
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Enumeration Date | 11/23/2005
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Last Update Date | 10/23/2007
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Provider Practice Location Address
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Address Line | 3751 KATELLA AVE
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-3101
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Country | US
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Telephone | 714-826-6400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 15718
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City | IRVINE
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State | CA
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Zip | 92623-5718
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Country | US
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Telephone | 949-263-8620
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Fax | 949-263-1639
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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 | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | G32752
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | G32752
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License Number State | CA
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