MEDICARE: DR. LYNN L. OWENS DC

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	111N00000X	Chiropractor	20732	CA

General Provider Information

NPI Number	:	1720088701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LYNN L. OWENS DC

Provider Business Mailing Address
First Line	:	4527 COLLEGE AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-4010
Country	:	US
Telephone Number	:	619-265-9336
Fax Number	:	619-583-2676

Provider Business Practice Location Address
First Line	:	4527 COLLEGE AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-4010
Country	:	US
Telephone Number	:	619-265-9336
Fax Number	:	619-583-2676

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

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	05/06/2013

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