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TKB FOWLER DO INC NPI 1215079892


NPI Information

NPI: 1215079892
Provider Name: TKB FOWLER DO INC

Doing Business As: GENESIS MEDICAL CLINIC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
6189 LA PALMA AVE
BUENA PARK, CA
ZIP 90620
Phone: (714) 522-2891
Get Directions

TKB FOWLER DO INC is a family medicine in Buena Park, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. TKB FOWLER DO INC NPI is 1215079892. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Genesis Medical Clinic.

The provider's business location address is:

6189 LA PALMA AVE
BUENA PARK, CA
ZIP 90620-858
Phone: (714) 522-2891
Fax: (714) 522-8176

The provider's authorized official is Terry Kb Fowler .
The authorized official title is President and has the following contact phone number (714) 522-2891.

The enumeration date for this NPI number is 2/12/2007 and was last updated on 7/3/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine00AX78810CALIFORNIANo
2207Q00000XFamily Medicine20A7613CALIFORNIANo
3207Q00000XFamily MedicineA43569CALIFORNIANo
4207Q00000XFamily Medicine20A7881CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1W16003MEDICARE UPIN
2W16003MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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