Provider Demographics
NPI:1174654586
Name:LOW, BRIAN KENT (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:KENT
Last Name:LOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:20401 SOUTH AVALON BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746
Mailing Address - Country:US
Mailing Address - Phone:310-632-5795
Mailing Address - Fax:310-632-5842
Practice Address - Street 1:20401 SOUTH AVALON BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746
Practice Address - Country:US
Practice Address - Phone:310-632-5795
Practice Address - Fax:310-632-5842
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG57531208100000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation