Provider Demographics
NPI:1295702710
Name:BOWMAN, PHILLIP JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:JAMES
Last Name:BOWMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9107 WILSHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5522
Mailing Address - Country:US
Mailing Address - Phone:310-276-4003
Mailing Address - Fax:310-276-4073
Practice Address - Street 1:9777 WILSHIRE BLVD STE 707
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-1907
Practice Address - Country:US
Practice Address - Phone:310-276-4003
Practice Address - Fax:310-276-4073
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA731522084P0800X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No174400000XOther Service ProvidersSpecialist