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Organization

REDDING UROLOGIC ASSOCIATES, A MEDICAL CORP

Active
Other names
Redding Urologic Associates
Organization subpart
No

Provider details

NPI number
Authorized official
PATRICK T FOWLER M.D. (CORPORATION OFFICER)
(530) 241-3316
Entity
Organization

Contact information

Practice address
2626 EDITH AVE STE C, REDDING, CA 96001-3056
(530) 241-3316
(530) 241-6319
Mailing address
2626 EDITH AVE STE C, REDDING, CA 96001-3056
(530) 241-3316
(530) 241-6319

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
332900000X
Non-Pharmacy Dispensing Site

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05D0617976
CLIA ID
CA
01
CP5241
RAILROAD MEDICARE
CA
05
ZZZ78528Z
CA
Enumeration date
09/26/2006
Last updated
08/13/2025
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