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NPI Code Detail

MEDICARE: LILY K FOWLER LCSW

MEDICARE: LILY K FOWLER LCSW
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
11041C0700XClinical Social WorkerLCS23195CA

General Provider Information

NPI Number : 1821121435
Entity Type Code : Individual
Provider Name (Legal Business Name) : LILY K FOWLER LCSW
Provider Business Mailing Address
First Line : 7120 FRANKLIN AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90046-3002
Country : US
Telephone Number : 213-637-5000
Fax Number :
Provider Business Practice Location Address
First Line : 7120 FRANKLIN AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90046-3002
Country : US
Telephone Number : 213-637-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2007
Last Update Date : 08/17/2022

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