Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | 20337 | CA |
NPI | 1245317585 |
---|---|
Provider Name | Dr. Douglas Joseph Owen |
First Address | Tulare, CA 93274-3217 |
Second Address | Tulare, CA 93274-3217 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/07/2007 |