Healthcare Provider Details

I. General information

NPI: 1992767321
Provider Name (Legal Business Name): MILTON LEROY OWENS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 07/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2617 E CHAPMAN AVE SUITE 307
ORANGE CA
92869-3226
US

IV. Provider business mailing address

2617 E CHAPMAN AVE SUITE 307
ORANGE CA
92869-3226
US

V. Phone/Fax

Practice location:
  • Phone: 714-997-4448
  • Fax: 714-997-4449
Mailing address:
  • Phone: 714-997-4448
  • Fax: 714-997-4449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberG27997
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: