Healthcare Provider Details

I. General information

NPI: 1861417412
Provider Name (Legal Business Name): JON MICHAEL ROWLAND M.D., PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 52ND ST ROOM 238
OAKLAND CA
94609-1809
US

IV. Provider business mailing address

252 DONALD DR
MORAGA CA
94556-2310
US

V. Phone/Fax

Practice location:
  • Phone: 510-428-3162
  • Fax: 510-601-3915
Mailing address:
  • Phone: 925-631-7096
  • Fax: 510-601-3915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0213X
TaxonomyPediatric Pathology Physician
License NumberG64565
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: