Provider Demographics
NPI:1396777215
Name:ROWE, VINCENT LOPEZ (MD)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:LOPEZ
Last Name:ROWE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5767 W CENTURY BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 UCLA MEDICAL PLZ STE 526
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-5331
Practice Address - Country:US
Practice Address - Phone:310-206-1182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG760692086S0129X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G760690OtherBLUE SHIELD PIN
CA00G760690C29OtherCAL OPTIMA PIN
CA020042771OtherMEDICARE RAILROAD
CA00G760690F94OtherCAL OPTIMA PIN
CA00G760690Medicaid
CABP197ZMedicare PIN
CAWG76069EMedicare PIN
CA00G760690Medicaid
CA00G760690OtherBLUE SHIELD PIN
CAW76069CMedicare PIN