Provider Demographics
NPI:1225000672
Name:BOWNS, GERALD THORPE (MD)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:THORPE
Last Name:BOWNS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CONGRESS ST
Mailing Address - Street 2:#340
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3023
Mailing Address - Country:US
Mailing Address - Phone:626-796-5325
Mailing Address - Fax:626-796-5526
Practice Address - Street 1:10 CONGRESS ST
Practice Address - Street 2:#340
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3023
Practice Address - Country:US
Practice Address - Phone:626-796-5325
Practice Address - Fax:626-796-5526
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA24388207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A243881Medicaid
CA00A243881Medicaid
CAA24388Medicare PIN
A23958Medicare UPIN