Provider Demographics
NPI:1043356413
Name:LOWE, ELIZABETH H (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:H
Last Name:LOWE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 TAMALPAIS DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1700
Mailing Address - Country:US
Mailing Address - Phone:415-945-8808
Mailing Address - Fax:415-945-8818
Practice Address - Street 1:770 TAMALPAIS DR
Practice Address - Street 2:SUITE 203
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1700
Practice Address - Country:US
Practice Address - Phone:415-945-8808
Practice Address - Fax:415-945-8818
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70427207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH56024Medicare UPIN
CA00A704271Medicare ID - Type UnspecifiedMEDICARE