Provider Demographics
NPI:1841268273
Name:BOWEN, THOMAS ADAM (DO)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ADAM
Last Name:BOWEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:T.
Other - Middle Name:ADAM
Other - Last Name:BOWEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:2005 COURT ST
Mailing Address - Street 2:SUITE J
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1807
Mailing Address - Country:US
Mailing Address - Phone:530-246-4733
Mailing Address - Fax:530-246-6019
Practice Address - Street 1:2005 COURT ST
Practice Address - Street 2:SUITE J
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1807
Practice Address - Country:US
Practice Address - Phone:530-246-4733
Practice Address - Fax:530-246-6019
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A 9097207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX90970Medicaid
CABB8802820OtherDEA NUMBER
CA020A90970Medicare ID - Type Unspecified
CA00AX90970Medicaid