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NPI Code Detail

MEDICARE: DR. JOHN C. LOWRY DO

MEDICARE: DR. JOHN C. LOWRY DO
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
12084P0800XPsychiatry Physician20A10380CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1BP629YOTHERCAMEDICARE PTAN

General Provider Information

NPI Number : 1477661619
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN C. LOWRY DO
Provider Business Mailing Address
First Line : PO BOX 609001
Second Line :
City : SAN DIEGO
State : CA
Zip : 92160-9001
Country : US
Telephone Number : 619-528-4600
Fax Number : 619-528-4625
Provider Business Practice Location Address
First Line : 1550 HOTEL CIR N STE 450
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-2933
Country : US
Telephone Number : 619-692-1581
Fax Number : 619-528-4625
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2006
Last Update Date : 03/15/2021

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