Provider Demographics
NPI:1952597338
Name:FOWLER, CURTIS B (PA)
Entity Type:Individual
Prefix:MR
First Name:CURTIS
Middle Name:B
Last Name:FOWLER
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:1600 CREEKSIDE DR
Mailing Address - Street 2:SUITE 2100
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3444
Mailing Address - Country:US
Mailing Address - Phone:916-983-2663
Mailing Address - Fax:916-983-0602
Practice Address - Street 1:1451 RIVER PARK DR STE 260
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-4504
Practice Address - Country:US
Practice Address - Phone:650-826-2945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA16519363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical