Provider Demographics
NPI:1396013298
Name:MCQUOWN, DENNIS SHAWN (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:SHAWN
Last Name:MCQUOWN
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 1:50338 SOLEDAD PL
Mailing Address - Street 2:
Mailing Address - City:COACHELLA
Mailing Address - State:CA
Mailing Address - Zip Code:92236-5481
Mailing Address - Country:US
Mailing Address - Phone:760-289-4753
Mailing Address - Fax:760-289-4753
Practice Address - Street 1:50338 SOLEDAD PL
Practice Address - Street 2:
Practice Address - City:COACHELLA
Practice Address - State:CA
Practice Address - Zip Code:92236-5481
Practice Address - Country:US
Practice Address - Phone:760-289-4753
Practice Address - Fax:760-289-4753
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA224462085U0001X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice