Active NPI
Benjamin F Cowan, MD
- Diagnostic Radiology Physician
- Los Alamitos, CA
National Provider Identifier
1760465728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- G32752
- Practice address
- 3751 Katella Ave
Los Alamitos, CA 90720-3101 - Phone
- (714) 826-6400
- NPI assigned
- Nov 23, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neuroradiology Physician | 2085N0700X | G32752 | CA | |
| Diagnostic Radiology Physician | 2085R0202X | G32752 | CA | Primary |
Addresses
Primary practice location
3751 Katella Ave
Los Alamitos, CA 90720-3101
Mailing address
PO Box 15718
Irvine, CA 92623-5718
Phone (949) 263-8620
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G327520 | Medicaid | CA | |
| P00319936 | Other | CA | RR MEDICARE |
| 00G327520 | Other | CA | BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G32752 | CA | MD | Neuroradiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memrad Medical Group Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Radiology Clinic/Center
- Long Beach, CA
- NPI 1831173905
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193097600000",
"number": "1760465728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 15718",
"city": "IRVINE",
"state": "CA",
"postal_code": "926235718",
"telephone_number": "949-263-8620",
"fax_number": "949-263-1639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3751 KATELLA AVE",
"city": "LOS ALAMITOS",
"state": "CA",
"postal_code": "907203101",
"telephone_number": "714-826-6400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COWAN",
"first_name": "BENJAMIN",
"middle_name": "F",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-23",
"last_updated": "2007-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "CA",
"license": "G32752",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "G32752",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G327520",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00319936",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "00G327520",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Alamitos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.