Individual
DR. VINCENT ROY FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9041 MAGNOLIA AVE STE 206, RIVERSIDE, CA 92503-3956
(951) 354-2220
(951) 354-2218
Mailing address
9041 MAGNOLIA AVE STE 206, RIVERSIDE, CA 92503-3956
(951) 354-2220
(951) 354-2218
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
42759
AZ
207N00000X
Dermatology Physician
A30049
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A300490
—
CA
Enumeration date
09/20/2006
Last updated
06/14/2019
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