Basic Information
| Provider Information | |||||||||
| NPI: | 1013979269 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LOWY | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | ARTHUR | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 652 PETALUMA AVE | ||||||||
| Address2: | SUITE F | ||||||||
| City: | SEBASTOPOL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 954724266 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7078232334 | ||||||||
| FaxNumber: | 7078233007 | ||||||||
| Practice Location | |||||||||
| Address1: | 652 PETALUMA AVE | ||||||||
| Address2: | SUITE F | ||||||||
| City: | SEBASTOPOL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 954724266 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7078232334 | ||||||||
| FaxNumber: | 7078233007 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2006 | ||||||||
| LastUpdateDate: | 01/06/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | G21122 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 00G211220 | 05 | CA | MEDICAID |