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| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | Owen Rowe McIvor | [sources] | |||
| Birth date | not available | [sources] | |||
| Nationality | not available | [sources] | |||
| Country | United States | [sources] | |||
| First name | Owen | [sources] | |||
| Last name | McIvor | [sources] | |||
| Middle name | Rowe | [sources] | |||
| NPI | 1538108337 | [sources] | |||
| Registration number | 00G678420 · G 67842 | [sources] | |||
| Sector | Physician | [sources] | |||
| Address | 11178 Walnut Street Redlands, CA 92374 | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers suspended from or otherwise deemed ineligible to participate in California's Medicaid program.
United States · DHCS
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