Provider Demographics
NPI:1114052503
Name:PAUL K. ROW, M.D., A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:PAUL K. ROW, M.D., A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:KUN
Authorized Official - Last Name:ROW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-686-2020
Mailing Address - Street 1:2225 PORT CHICAGO HWY STE A
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2154
Mailing Address - Country:US
Mailing Address - Phone:925-686-2020
Mailing Address - Fax:
Practice Address - Street 1:2225 PORT CHICAGO HWY STE A
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2154
Practice Address - Country:US
Practice Address - Phone:925-686-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9682T152W00000X
CAA74103207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADB9097OtherRAILROAD MEDICARE
CADB9097Medicare PIN
CADB9097OtherRAILROAD MEDICARE
CA0827250001Medicare NSC