MEDICARE: MR. DENNIS GENE LOWMAN O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	8787	CA
2	152WC0802X	Corneal and Contact Management Optometrist	OPT8787T	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6685580001	OTHER	CA	NORIDIAN MEDICARE REGION D
5	FU077A	OTHER	CA	MEDICARE GROUP NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1245517804	OTHER	CA	GROUP NPI
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134103484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DENNIS GENE LOWMAN O.D.

Provider Business Mailing Address
First Line	:	56970 YUCCA TRL
Second Line	:
City	:	YUCCA VALLEY
State	:	CA
Zip	:	92284-3753
Country	:	US
Telephone Number	:	760-228-2020
Fax Number	:	760-369-2020

Provider Business Practice Location Address
First Line	:	56970 YUCCA TRL
Second Line	:
City	:	YUCCA VALLEY
State	:	CA
Zip	:	92284-3753
Country	:	US
Telephone Number	:	760-228-2020
Fax Number	:	760-369-2020

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	10/10/2019

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