Active NPI
Owen R McIvor, M.D.
- Orthopaedic Surgery Physician
- Highland, CA
National Provider Identifier
1538108337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- G67842
- Practice address
- 7000 Boulder Ave
Highland, CA 92346-3348 - Phone
- (909) 862-1191
- Fax
- (909) 796-4158
- NPI assigned
- Jun 6, 2006
- Last updated
- Jul 13, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | G67842 | CA | Primary |
Addresses
Primary practice location
7000 Boulder Ave
Highland, CA 92346-3348
Mailing address
PO Box 10069
San Bernardino, CA 92423-0069
Phone (909) 335-4188
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G678420 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
Interoperability endpoints
- omcivor11116@epiclp.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1538108337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10069",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924230069",
"telephone_number": "909-335-4188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7000 BOULDER AVE",
"city": "HIGHLAND",
"state": "CA",
"postal_code": "923463348",
"telephone_number": "909-862-1191",
"fax_number": "909-796-4158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCIVOR",
"first_name": "OWEN",
"middle_name": "R",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "CA",
"license": "G67842",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G678420",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Highland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.