Healthcare Provider Details

I. General information

NPI: 1871547554
Provider Name (Legal Business Name): NORMAN D. OWASHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 S SUNSET AVE
WEST COVINA CA
91790-3940
US

IV. Provider business mailing address

639 SPUR TRAIL AVE
WALNUT CA
91789-2047
US

V. Phone/Fax

Practice location:
  • Phone: 626-814-2434
  • Fax:
Mailing address:
  • Phone: 909-594-6135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberG45369
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: