Provider Demographics
NPI:1508842683
Name:ROWEN, DAVID WAYNE (CRNA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:WAYNE
Last Name:ROWEN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4150 V ST
Mailing Address - Street 2:PSSB-SUITE 1200, MED: ANESTHESIA
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-1460
Mailing Address - Country:US
Mailing Address - Phone:916-734-7985
Mailing Address - Fax:916-734-2975
Practice Address - Street 1:4150 V ST
Practice Address - Street 2:PSSB-SUITE 1200, MED: ANESTHESIA
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-1460
Practice Address - Country:US
Practice Address - Phone:916-734-7985
Practice Address - Fax:916-734-2975
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA458438/2390 RN/CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA006990OtherPHYSICIAN INDEX #
CA006990OtherPHYSICIAN INDEX #
CAZZZ14512ZMedicare ID - Type Unspecified