Provider Demographics
NPI:1003060427
Name:LOWERY, EUGENE (DC)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:
Last Name:LOWERY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:EUGENE
Other - Middle Name:
Other - Last Name:LOWERY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:550 W VISTA WAY
Mailing Address - Street 2:SUITE 104
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92083-5732
Mailing Address - Country:US
Mailing Address - Phone:769-941-1900
Mailing Address - Fax:
Practice Address - Street 1:550 W VISTA WAY
Practice Address - Street 2:SUITE 104
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-5732
Practice Address - Country:US
Practice Address - Phone:760-941-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-12
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC013346111N00000X
CAAC9245171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA91-2142859OtherEIN