Provider Demographics
NPI:1649375015
Name:BOWER, ANDREA (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:BOWER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8151 ARLINGTON AVE
Mailing Address - Street 2:SUITE U-V
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-0436
Mailing Address - Country:US
Mailing Address - Phone:951-588-0861
Mailing Address - Fax:951-588-1910
Practice Address - Street 1:617 E ALVARADO ST
Practice Address - Street 2:
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-2315
Practice Address - Country:US
Practice Address - Phone:760-728-3816
Practice Address - Fax:760-728-1542
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG036954207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA46881Medicare UPIN