Individual
DR. DAVID EDWARD POWLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1110 CALIFORNIA BLVD, SUITE A, SAN LUIS OBISPO, CA 93401-2949
(805) 546-2104
(805) 545-7716
Mailing address
1110 CALIFORNIA BLVD, SUITE A, SAN LUIS OBISPO, CA 93401-2949
(805) 546-2104
(805) 545-7716
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G36054
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G36054
MEDICAL LICENSE
CA
Enumeration date
10/10/2006
Last updated
07/08/2007
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