Provider Demographics
NPI:1497347975
Name:BOWEN, RICHARD B JR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:B
Last Name:BOWEN
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5600 CALIFORNIA AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-1614
Mailing Address - Country:US
Mailing Address - Phone:661-322-2700
Mailing Address - Fax:
Practice Address - Street 1:5600 CALIFORNIA AVE STE 101
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-1614
Practice Address - Country:US
Practice Address - Phone:661-322-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-06
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3720363A00000X
CA61933363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant