Basic Information
| Provider Information | |||||||||
| NPI: | 1295702710 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOWMAN | ||||||||
| FirstName: | PHILLIP | ||||||||
| MiddleName: | JAMES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9107 WILSHIRE BLVD | ||||||||
| Address2: | |||||||||
| City: | BEVERLY HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902105522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102764003 | ||||||||
| FaxNumber: | 3102764073 | ||||||||
| Practice Location | |||||||||
| Address1: | 9777 WILSHIRE BLVD STE 707 | ||||||||
| Address2: | |||||||||
| City: | BEVERLY HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902121907 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102764003 | ||||||||
| FaxNumber: | 3102764073 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2006 | ||||||||
| LastUpdateDate: | 02/07/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | A73152 | CA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 174400000X | A73152 | CA | N | Other Service Providers | Specialist |
No ID Information.