Healthcare Provider Details

I. General information

NPI: 1457360927
Provider Name (Legal Business Name): MARALEE CARTNER BOWERS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 DOLPHIN AVE
SEAL BEACH CA
90740-6564
US

IV. Provider business mailing address

PO BOX 931
GRIDLEY CA
95948-0931
US

V. Phone/Fax

Practice location:
  • Phone: 314-888-5233
  • Fax: 844-689-5312
Mailing address:
  • Phone: 530-370-9235
  • Fax: 844-689-5312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036114686
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA110564
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: