Provider Demographics
NPI:1134420839
Name:TOWER, IRENE MARIA (MD)
Entity type:Individual
Prefix:DR
First Name:IRENE
Middle Name:MARIA
Last Name:TOWER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8680 MONROE CT STE 200
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-9104
Mailing Address - Country:US
Mailing Address - Phone:832-868-9830
Mailing Address - Fax:
Practice Address - Street 1:8680 MONROE CT STE 200
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-9104
Practice Address - Country:US
Practice Address - Phone:909-987-0899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-11
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD435265208600000X
CAA116059208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery