Provider Demographics
NPI:1639111628
Name:OWEN, ROBERT LEO (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LEO
Last Name:OWEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4150 CLEMENT ST
Mailing Address - Street 2:VA MEDICAL CENTER 11C1
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-1545
Mailing Address - Country:US
Mailing Address - Phone:415-750-2101
Mailing Address - Fax:415-750-2249
Practice Address - Street 1:4150 CLEMENT ST
Practice Address - Street 2:VA MEDICAL CENTER 11C1
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-1545
Practice Address - Country:US
Practice Address - Phone:415-750-2101
Practice Address - Fax:415-750-2249
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG15034207RG0100X
LA2759R207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology