Provider Demographics
NPI:1861437816
Name:FOWER, FRANK (MD,FACEP)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:
Last Name:FOWER
Suffix:
Gender:M
Credentials:MD,FACEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10832 WRIGHTWOOD LN
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-3952
Mailing Address - Country:US
Mailing Address - Phone:323-822-3342
Mailing Address - Fax:323-822-3342
Practice Address - Street 1:1700 COFFEE RD
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-2803
Practice Address - Country:US
Practice Address - Phone:209-572-7251
Practice Address - Fax:209-571-3342
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC50063207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C500630Medicaid
CA00C500630Medicaid
CAWC50063Medicare ID - Type Unspecified
CAAW070UMedicare PIN
CAAW070ZMedicare PIN