Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | A55750 | CA |
Y | 207YP0228X | Pediatric Otolaryngology | A55750 | CA |
NPI | 1376575175 |
---|---|
Provider Name | Mark R Rowe |
First Address | Madera, CA 93636-8761 |
Second Address | Madera, CA 93636-8761 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 18/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A557500 | (05) | CA |