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Organization
OWENS PEAK MEDICAL CLINIC INC
Active
Organization
OWENS PEAK MEDICAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANCINA VAN DONGEN (CFO)
(760) 375-0100
Entity
Organization
Contact information
Practice address
1131 N CHINA LAKE BLVD, RIDGECREST, CA 93555-3131
(760) 375-0100
(760) 375-0110
Mailing address
PO BOX 99, RIDGECREST, CA 93556-0099
(760) 375-0100
(760) 375-0110
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A40869
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A40869
—
CA
Enumeration date
02/08/2006
Last updated
02/12/2020
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