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General NPI Number Information
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NPI Number | 1518150564
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Entity Type | Organization
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Legal Business Name | LIVERMORE PRIMARY CARE MEDICAL ASSOCIATES, INC.
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Dates
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Enumeration Date | 08/23/2007
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Last Update Date | 06/17/2014
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Provider Practice Location Address
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Address Line | 42 FENTON ST
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City | LIVERMORE
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State | CA
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Zip | 94550-4144
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Country | US
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Telephone | 925-443-3232
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Fax | 925-443-3239
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Provider Business Mailing Address
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Address Line | 42 FENTON ST
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City | LIVERMORE
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State | CA
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Zip | 94550-4144
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Country | US
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Telephone | 925-443-3232
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Fax | 925-443-3239
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. RAYMOND JOSEPH ROWELL
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Credential | MD
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Telephone | 925-443-3232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State | CA
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