Provider Demographics
NPI:1619907250
Name:OWENS, MARK P (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:P
Last Name:OWENS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 2607
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95609-2607
Mailing Address - Country:US
Mailing Address - Phone:916-202-9889
Mailing Address - Fax:916-537-5111
Practice Address - Street 1:6501 COYLE AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-0306
Practice Address - Country:US
Practice Address - Phone:916-202-9889
Practice Address - Fax:916-537-5111
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2014-02-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG1341002086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA38964Medicare UPIN