Provider Demographics
NPI:1144299355
Name:OWEN, JAMES PATRICK (OD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PATRICK
Last Name:OWEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:681 ENCINITAS BLVD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-3762
Mailing Address - Country:US
Mailing Address - Phone:760-436-1877
Mailing Address - Fax:760-632-7319
Practice Address - Street 1:681 ENCINITAS BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-3762
Practice Address - Country:US
Practice Address - Phone:760-436-1877
Practice Address - Fax:760-632-7319
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2011-09-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA8966T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA8966TOtherLICENSE NUMBER
CAU20618Medicare UPIN