Fowlis, Mark Richardson

Fowlis, Mark Richardson is an individual health care provider with primary practice located at 11777 Sebastian Way Ste 102 , Rancho Cucamonga CA 91730. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Fowlis, Mark Richardson can be contacted via phone (909) 838-0044.

Contact Information

Primary practice address
11777 Sebastian Way Ste 102 Rancho Cucamonga CA 91730
Phone: (909) 838-0044
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1285904326
LBN Legal business name Fowlis, Mark Richardson
Credentials CAADE
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 6th, 2012
Last updated Jan 6th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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