Provider Demographics
NPI:1609946771
Name:BOWES, RICHARD KOURTNEY (MD)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:KOURTNEY
Last Name:BOWES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 BAY RD
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-1607
Mailing Address - Country:US
Mailing Address - Phone:707-628-9214
Mailing Address - Fax:
Practice Address - Street 1:709 BAY RD
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-1607
Practice Address - Country:US
Practice Address - Phone:707-628-9214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94484207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine