Healthcare Provider Details

I. General information

NPI: 1295933190
Provider Name (Legal Business Name): DEBRA MAGILL LOWRY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34800 BOB WILSON DR NMCSD
SAN DIEGO CA
92134-1098
US

IV. Provider business mailing address

13565 MILLPOND WAY
SAN DIEGO CA
92129-2048
US

V. Phone/Fax

Practice location:
  • Phone: 619-523-8250
  • Fax:
Mailing address:
  • Phone: 301-943-7197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberC171263
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberC171263
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: