=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801321948
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOWELL HEALTHCARE MP INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/26/2017
-----------------------------------------------------
Last Update Date | 01/22/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 35 W LOS ANGELES AVE
-----------------------------------------------------
City | MOORPARK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93021-1820
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-529-5370
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 35 W LOS ANGELES AVE
-----------------------------------------------------
City | MOORPARK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93021-1820
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-529-5370
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PRESIDENT
-----------------------------------------------------
Name | DR. MICHAEL HOWELL
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 818-515-5268
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | A114490
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | PA17596
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 52964
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | A37114
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 261QU0200X
-----------------------------------------------------
Taxonomy Name | Urgent Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #6
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | A118799
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------