Provider Demographics
NPI:1003075557
Name:CAROLYN R TOWLER MD INC
Entity Type:Organization
Organization Name:CAROLYN R TOWLER MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:TOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-493-7696
Mailing Address - Street 1:2218 GRAHAM AVE
Mailing Address - Street 2:UNIT B
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-2030
Mailing Address - Country:US
Mailing Address - Phone:310-493-7696
Mailing Address - Fax:310-370-0234
Practice Address - Street 1:2218 GRAHAM AVE
Practice Address - Street 2:UNIT B
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-2030
Practice Address - Country:US
Practice Address - Phone:310-493-7696
Practice Address - Fax:310-370-0234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2085B0100X, 2085R0202X, 2085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Single Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF29614Medicare UPIN