Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 59334 | MN |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 62501 | CO |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | A168934 | CA |
NPI | 1316353949 |
---|---|
Provider Name | Mark Bowers |
First Address | San Diego, CA 92123-2762 |
Second Address | San Diego, CA 92123-2762 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2014 |
Last Update Date | 16/07/2021 |