Provider Demographics
NPI:1548203904
Name:ROWEN, SHERI L (MD)
Entity Type:Individual
Prefix:DR
First Name:SHERI
Middle Name:L
Last Name:ROWEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4220 VON KARMAN AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2044
Mailing Address - Country:US
Mailing Address - Phone:949-854-7400
Mailing Address - Fax:
Practice Address - Street 1:4220 VON KARMAN AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2044
Practice Address - Country:US
Practice Address - Phone:949-854-7400
Practice Address - Fax:949-234-8295
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD29764207W00000X
CAC131504207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD511805101Medicaid
293L / 293LMedicare ID - Type Unspecified
E27042Medicare UPIN
MDKZ41 / 646429-01OtherBC / BS OF MD
MDS186 / S186OtherBLUECHOICE