| Michael T Bowersox Md Inc | |
|
16613 Wikiup Rd Ramona CA 92065-4161 | |
| (858) 243-2851 | |
| (760) 748-6800 |
| Full Name | Michael T Bowersox Md Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 16613 Wikiup Rd, Ramona, California |
| Authorized Official Name and Position | Michael T Bowersox (PHYSICIAN) |
| Authorized Official Contact | 7605000265 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael T Bowersox Md Inc Po Box 486 Ramona CA 92065-0486 Ph: (858) 243-2851 | Michael T Bowersox Md Inc 16613 Wikiup Rd Ramona CA 92065-4161 Ph: (858) 243-2851 |
| NPI Number | 1841628393 |
|---|---|
| Provider Enumeration Date | 10/20/2013 |
| Last Update Date | 01/14/2014 |
| Medicare PECOS PAC ID | 6709019060 |
|---|---|
| Medicare Enrollment ID | O20140513000190 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841628393 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G053320 (California) | Primary |
| Provider Name | Michael T Bowersox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285652818 PECOS PAC ID: 0143350322 Enrollment ID: I20100615000288 |
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