Provider Demographics
NPI:1568159028
Name:BOWDEN, AUSTIN OUTLAW (DO)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:OUTLAW
Last Name:BOWDEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11662 SOLAIRE WAY
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-7227
Mailing Address - Country:US
Mailing Address - Phone:909-557-5737
Mailing Address - Fax:
Practice Address - Street 1:315 MERCY AVE
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-8363
Practice Address - Country:US
Practice Address - Phone:209-564-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program