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General NPI Number Information
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NPI Number | 1891714325
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Entity Type | Individual
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Provider Name | JOHN DANIEL COWAN MD
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Gender | Male
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 01/09/2008
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Provider Practice Location Address
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Address Line | 150 PIONEER LN
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City | BISHOP
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State | CA
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Zip | 93514-2556
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Country | US
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Telephone | 760-873-5811
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Fax | 760-873-5811
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Provider Business Mailing Address
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Address Line | 5 HOLLAND STE 101
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City | IRVINE
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State | CA
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Zip | 92618-2568
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Country | US
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Telephone | 949-588-2190
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Fax | 949-588-2199
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 30679
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | C50218
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License Number State | CA
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