Individual
DR. BLAINE ALSIN FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8071 CUYAMACA ST, SANTEE, CA 92071
(619) 568-8025
(619) 568-8095
Mailing address
8701 CUYAMACA ST, SANTEE, CA 92071
(619) 568-8025
(619) 568-8095
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G36980
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ36915Z
—
CA
Enumeration date
02/10/2006
Last updated
10/09/2020
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