MEDICARE: MR. ERIC BOWEN CALL NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	400787	CA

General Provider Information

NPI Number	:	1568454866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ERIC BOWEN CALL NP

Provider Business Mailing Address
First Line	:	PO BOX 248
Second Line	:	1120 FOREST WAY
City	:	BROOKDALE
State	:	CA
Zip	:	95007-0248
Country	:	US
Telephone Number	:	831-338-7167
Fax Number	:

Provider Business Practice Location Address
First Line	:	751 S BASCOM AVE
Second Line	:	LABOR & DELIVERY
City	:	SAN JOSE
State	:	CA
Zip	:	95128-2604
Country	:	US
Telephone Number	:	408-885-6400
Fax Number	:	408-885-6454

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	07/08/2007

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