Provider Demographics
NPI:1396885901
Name:BOWMAN, TIMOTHY N (PT)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:N
Last Name:BOWMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94041-1709
Mailing Address - Country:US
Mailing Address - Phone:650-964-6269
Mailing Address - Fax:
Practice Address - Street 1:866 CAMPUS DR
Practice Address - Street 2:PT DEPT., VADEN HEALTH CENTER, STANFORD UNIVERSITY
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-8508
Practice Address - Country:US
Practice Address - Phone:650-723-3195
Practice Address - Fax:650-723-4999
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9424225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist