Provider Demographics
NPI:1417005448
Name:BOWES, CAMMY (DO)
Entity Type:Individual
Prefix:
First Name:CAMMY
Middle Name:
Last Name:BOWES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CAMMY
Other - Middle Name:
Other - Last Name:TSAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:2055 KELLOGG AVE
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-3111
Mailing Address - Country:US
Mailing Address - Phone:951-898-7327
Mailing Address - Fax:
Practice Address - Street 1:2055 KELLOGG AVE
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-3111
Practice Address - Country:US
Practice Address - Phone:951-898-7327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9466207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine