Most Relevant Information
Provider Data
| NPI Number: | 1003388729 |
| Provider Name: | AMANDA COWAN |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/19/2018 |
| Last Updated: | 12/19/2018 |
Provider Practice Location
5220 W WASHINGTON BLVD
LOS ANGELES
CA
900161331
Practice Location Phone/Fax
| Phone: | 3103146200 |
| Fax: |
Provider Mailing Location
2644 30TH ST STE 100
SANTA MONICA
CA
904053051
Provider Mailing Phone/Fax
| Phone: | 3103146200 |
| Fax: | 3104502024 |