Provider Demographics
NPI:1619008026
Name:ROWAT, RITA WINONA (MD)
Entity Type:Individual
Prefix:DR
First Name:RITA
Middle Name:WINONA
Last Name:ROWAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:R
Other - Middle Name:WINONA
Other - Last Name:ROWAT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2743 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-7410
Mailing Address - Country:US
Mailing Address - Phone:619-474-2284
Mailing Address - Fax:619-474-3919
Practice Address - Street 1:2743 HIGHLAND AVE
Practice Address - Street 2:SAMAHAN MEDICAL CLINIC
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-7410
Practice Address - Country:US
Practice Address - Phone:619-474-2284
Practice Address - Fax:619-474-3919
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG071634207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG071634Medicaid