MEDICARE: MR. WILLIAM OWENS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator		CA

General Provider Information

NPI Number	:	1093872764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM OWENS

Provider Business Mailing Address
First Line	:	349 E AVENUE K6 STE A
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93535-4548
Country	:	US
Telephone Number	:	661-723-4260
Fax Number	:

Provider Business Practice Location Address
First Line	:	349 E AVENUE K6 STE A
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93535-4548
Country	:	US
Telephone Number	:	661-723-4260
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	03/23/2021

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