Provider Demographics
NPI:1720015902
Name:MCGOWAN, MARK SCHEER (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:SCHEER
Last Name:MCGOWAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5767 W CENTURY BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:310-656-1702
Mailing Address - Fax:310-458-1061
Practice Address - Street 1:1260 15TH ST
Practice Address - Street 2:1501
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1135
Practice Address - Country:US
Practice Address - Phone:310-656-1700
Practice Address - Fax:310-458-1061
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2020-02-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG39850207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG38950DMedicare PIN
CAA47645Medicare UPIN