Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | G30403 | CA |
N | 208600000X | Surgeon | G30403 | CA |
Y | 2086X0206X | Surgical Oncologist | G30403 | CA |
NPI | 1124124722 |
---|---|
Provider Name | Dr. Jay C Owens |
First Address | Sacramento, CA 95827-2539 |
Second Address | Roseville, CA 95661-3087 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 28/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G304030 | (05) | CA |
A44411 | (02) |