Healthcare Provider Details

I. General information

NPI: 1902847841
Provider Name (Legal Business Name): DOUGLAS H OWYANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 11/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 CONSTITUTION BLVD BLDG. 151, SUITE 16
SALINAS CA
93906-3100
US

IV. Provider business mailing address

1615 BUNKER HILL WAY SUITE 100
SALINAS CA
93906-6013
US

V. Phone/Fax

Practice location:
  • Phone: 831-769-8640
  • Fax: 831-769-8632
Mailing address:
  • Phone: 831-796-1304
  • Fax: 831-757-0291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA26061
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: