Provider Demographics
NPI:1609803386
Name:LOWEN, MARY (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:LOWEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:110 SUTTER ST
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-4002
Mailing Address - Country:US
Mailing Address - Phone:415-291-0480
Mailing Address - Fax:415-291-0489
Practice Address - Street 1:110 SUTTER ST
Practice Address - Street 2:6TH FLOOR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-4002
Practice Address - Country:US
Practice Address - Phone:415-291-0480
Practice Address - Fax:415-291-0489
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2014-08-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG37005207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA46907Medicare UPIN