Healthcare Provider Details

I. General information

NPI: 1871797118
Provider Name (Legal Business Name): DAVID ROW M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 07/03/2024
Certification Date: 07/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11370 ANDERSON ST STE 2100
LOMA LINDA CA
92354-3450
US

IV. Provider business mailing address

11370 ANDERSON ST STE 2100
LOMA LINDA CA
92354-3450
US

V. Phone/Fax

Practice location:
  • Phone: 909-558-2822
  • Fax: 909-558-2404
Mailing address:
  • Phone: 909-558-2822
  • Fax: 909-558-2404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberA120226
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: