Kristi Bowen
Individual provider Active NPI Specialist · Galt, CA
NPI 1992129258 · NPPES record last updated Feb 7, 2014
Key facts
- NPI
- 1992129258
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 140001144 (CA)
- Practice address
- 234 Cinnamon Dr
Galt, CA 95632-2430 - Phone
- (724) 290-0224
- NPI assigned
- Feb 7, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 130207983 | CA | MD | Specialist |
| 140001144 | CA | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 130207983 | CA | |
| Specialist | 174400000X | 140001144 | CA | Yes |
Addresses
Primary practice location
234 Cinnamon Dr
Galt, CA 95632-2430
Mailing address
234 Cinnamon Dr
Galt, CA 95632-2430
Phone (724) 290-0224
Other providers in Galt, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 7, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.