Healthcare Provider Details

I. General information

NPI: 1528976883
Provider Name (Legal Business Name): CURTIS OWENS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2621 CASITA DR
MODESTO CA
95355-3424
US

IV. Provider business mailing address

931 10TH ST
MODESTO CA
95354-2305
US

V. Phone/Fax

Practice location:
  • Phone: 209-654-1408
  • Fax:
Mailing address:
  • Phone: 209-834-4761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471C3402X
TaxonomyRadiography Radiologic Technologist
License Number20280731
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: