Provider Demographics
NPI:1700884905
Name:KOWELL, ARTHUR P (MD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:P
Last Name:KOWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16311 VENTURA BLVD
Mailing Address - Street 2:SUITE 680
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2124
Mailing Address - Country:US
Mailing Address - Phone:818-990-8561
Mailing Address - Fax:818-990-4432
Practice Address - Street 1:16311 VENTURA BLVD
Practice Address - Street 2:SUITE 680
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2124
Practice Address - Country:US
Practice Address - Phone:818-990-8561
Practice Address - Fax:818-990-4432
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG029779174400000X
CAG297792084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G297790Medicaid
CAA44158Medicare UPIN
CABR676ZMedicare PIN