Healthcare Provider Details

I. General information

NPI: 1205988854
Provider Name (Legal Business Name): OWEN HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1109 VICENTE STREET SUITE 103
SAN FRANCISCO CA
94116-3082
US

IV. Provider business mailing address

1881 W TRAVERSE PKWY STE E#112
LEHI UT
84048-6029
US

V. Phone/Fax

Practice location:
  • Phone: 415-682-2111
  • Fax: 415-682-2112
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number070000580
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number05D0911970
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number220000345
License Number StateCA

VIII. Authorized Official

Name: MR. STEVE BURNINGHAM
Title or Position: CEO
Credential:
Phone: 415-845-3213