Provider Demographics
NPI:1124124722
Name:OWENS, JAY C (MD)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:C
Last Name:OWENS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10470 OLD PLACERVILLE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2539
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:3 MEDICAL PLAZA DR
Practice Address - Street 2:SUITE 130
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3087
Practice Address - Country:US
Practice Address - Phone:916-773-8750
Practice Address - Fax:916-773-8751
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2015-10-28
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Provider Licenses
StateLicense IDTaxonomies
CAG30403208600000X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G304030Medicaid
CA00G304030Medicaid
CA00G304031Medicare PIN
CA00G304031Medicare PIN