Provider Demographics
NPI:1639317266
Name:KAROL BOWENS,M.D., A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:KAROL BOWENS,M.D., A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWENS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-930-3623
Mailing Address - Street 1:PO BOX 696
Mailing Address - Street 2:
Mailing Address - City:LYNWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90262-0696
Mailing Address - Country:US
Mailing Address - Phone:310-930-3623
Mailing Address - Fax:
Practice Address - Street 1:3621 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262-3512
Practice Address - Country:US
Practice Address - Phone:310-930-3623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54708207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty