MEDICARE: FOUNTAIN VALLEY INTEGRATIVE PHYSICAL MEDICINE

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	208100000X	Physical Medicine & Rehabilitation Physician	A45146	CA

General Provider Information

NPI Number	:	1942642533
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOUNTAIN VALLEY INTEGRATIVE PHYSICAL MEDICINE

Provider Business Mailing Address
First Line	:	18042 MAGNOLIA ST
Second Line	:
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708-5603
Country	:	US
Telephone Number	:	714-962-1674
Fax Number	:	714-964-9624

Provider Business Practice Location Address
First Line	:	18042 MAGNOLIA ST
Second Line	:
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708-5603
Country	:	US
Telephone Number	:	714-962-1674
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	MICHAEL LOWENSTEIN
Credential	:
Telephone Number	:	714-962-1674

Provider Enumeration Date	:	07/23/2013
Last Update Date	:	01/27/2026

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