Provider Demographics
NPI:1770994535
Name:COWELL HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:COWELL HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:COWELL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:949-448-0872
Mailing Address - Street 1:27432 ALISO CREEK RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-5337
Mailing Address - Country:US
Mailing Address - Phone:949-448-0872
Mailing Address - Fax:949-448-0984
Practice Address - Street 1:27432 ALISO CREEK RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-5337
Practice Address - Country:US
Practice Address - Phone:949-448-0872
Practice Address - Fax:949-448-0984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-15
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT24719261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy