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General NPI Number Information
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NPI Number | 1962989608
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Entity Type | Individual
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Provider Name | LORIN TODD MOWREY MD
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Gender | Male
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Dates
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Enumeration Date | 07/25/2018
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Last Update Date | 11/22/2022
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Provider Practice Location Address
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Address Line | 2500 E VAN BUREN ST
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City | PHOENIX
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State | AZ
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Zip | 85008-6037
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Country | US
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Telephone | 602-685-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 8135 N 35TH AVE APT 1110
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City | PHOENIX
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State | AZ
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Zip | 85051-5877
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Country | US
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Telephone | 602-334-9609
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Fax |
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A165485
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 67783
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License Number State | AZ
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