Provider Demographics
NPI:1962173294
Name:OWEN B TOWERY MD
Entity type:Organization
Organization Name:OWEN B TOWERY MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:MARTINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-943-1035
Mailing Address - Street 1:3478 BUSKIRK AVE STE 219
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-4346
Mailing Address - Country:US
Mailing Address - Phone:925-943-1035
Mailing Address - Fax:925-952-4032
Practice Address - Street 1:3478 BUSKIRK AVE STE 219
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-4346
Practice Address - Country:US
Practice Address - Phone:925-943-1035
Practice Address - Fax:925-952-4032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-27
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)