Andrea Bower, M.D.
Individual provider Active NPI Family Medicine Physician · Fallbrook, CA
NPI 1649375015 · NPPES record last updated Sep 14, 2007
Key facts
- NPI
- 1649375015
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- G036954 (CA)
- Practice address
- 617 E Alvarado St
Fallbrook, CA 92028-2315 - Phone
- (760) 728-3816
- Fax
- (760) 728-1542
- NPI assigned
- Sep 13, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050311000757 | CA | Practitioner - Family Practice | 4385698356 |
Reassigns benefits to 1 organization Practice locations: San Diego, CA |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G036954 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Emergency Medicine | Current | Accepting new patients | |
| Southern California Emergency Medicine | Current |
Accepting new patients | |
| Southern California Emergency Medicine | Current |
Accepting new patients | |
| Terry D. Ahn DDS., Inc | Past | Accepting new patients | |
| Tricare Outpatient Clinic Clairemont | Past | Accepting new patients |
Locations
1407 Foothill Blvd
La Verne, CA 91750
Phone (909) 596-3577
1295 Hamner Ave
Ste C
Norco, CA 92860
Phone (951) 272-6500
33494 Oak Glen Rd
Yucaipa, CA 92399
Phone (909) 797-8900
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G036954 | CA | Yes |
Addresses
Primary practice location
617 E Alvarado St
Fallbrook, CA 92028-2315
Mailing address
8151 Arlington Ave
Suite U-V
Riverside, CA 92503-0436
Phone (951) 588-0861
Other providers in Fallbrook, CA
- Robert William Bolinger
- Christa Glorybe Vallar Bondoc
- Melissa Borst
- Chelsea Brianne Bowden
- Susana Bowen
- Bramhall Dental Corp
- Ryan Eugene Bramhall
- Talitha Jannelle Brewer
- Brian Wayne Miller
- David Bridgeman
All providers in Fallbrook, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.