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General NPI Number Information
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NPI Number | 1780864298
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Entity Type | Organization
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Legal Business Name | BOWMAN PSYCHIATRIC, A MEDICAL CORPORATION
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Dates
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Enumeration Date | 11/13/2007
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Last Update Date | 07/17/2009
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Provider Practice Location Address
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Address Line | 9777 WILSHIRE BLVD STE. 707
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-1910
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Country | US
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Telephone | 310-276-4003
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Fax |
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Provider Business Mailing Address
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Address Line | 9777 WILSHIRE BLVD STE. 707
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-1910
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | PHILLIP JAMES BOWMAN
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Credential | M.D
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Telephone | 310-276-4003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP0016X
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Taxonomy Name | Prescribing (Medical) Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number | A73152
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License Number State | CA
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