Alfred Bowen Jr.

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

74630 Issued in CA

Practice address

2651 Irvine Ave Ste 122
Costa Mesa, CA 92627-6645

Phone

(214) 669-0424

NPI assigned

Jan 14, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1366082653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E 3RD ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014940",
            "telephone_number": "214-669-0424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 IRVINE AVE STE 122",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926276645",
            "telephone_number": "214-669-0424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "ALFRED",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-14",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "74630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASSOCIATED BODYWORK & MASSAGE PROFESSIONALS",
            "identifier": "API-ABMP-17",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "se.mpt@massagetherapy.com",
            "affiliation": "N",
            "endpointDescription": "Business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1111 E 3rd St",
            "city": "Santa Ana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927014940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alessandra Botello
• Nabil Botros
• Elliot Bouchan-Boche
• Troy David Boughner, PHARMD
• Michael Paul Bourgoin, O.D.
• Caylin Mariah Bowen
• Macy Bowls
• Shawnna Boyd-Morrison, N.P.
• Barry J Boyd II, D.C.
• Caroline Boyd, P.T.

• Massage Therapist in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.