Individual
BENJAMIN F COWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3751 KATELLA AVE, LOS ALAMITOS, CA 90720-3101
(714) 826-6400
Mailing address
PO BOX 15718, IRVINE, CA 92623-5718
(949) 263-8620
(949) 263-1639
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
G32752
CA
2085R0202X
Diagnostic Radiology Physician
Primary
G32752
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G327520
BLUE SHIELD
CA
05
—
00G327520
—
CA
01
—
P00319936
RR MEDICARE
CA
Enumeration date
11/23/2005
Last updated
10/23/2007
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