Glen Bowman, MD | |
1900 Sullivan Ave, Daly City, CA 94015-2200 | |
(408) 354-9254 | |
(918) 213-4399 |
Full Name | Glen Bowman |
---|---|
Gender | Male |
Speciality | Anesthesiology |
Location | 1900 Sullivan Ave, Daly City, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1922110238 | NPI | - | NPPES |
806868300 | Medicaid | ID | |
835388 | Other | UT | HEALTHY U |
77515 | Other | UT | PEHP |
QM0000075886 | Other | UT | ALTIUS |
870545614BOW | Other | UT | EDUCATORS MUTUAL |
TPRA09326 | Other | UT | MOLINA |
2090168 | Other | UT | UNITED HEALTHCARE |
100503208 | Medicaid | NV | |
1502954 | Other | UT | UMWA |
858409 | Medicaid | AZ | |
107028042101 | Other | UT | IHC |
119647200 | Medicaid | WY | |
851001 | Other | UT | DESERET MUTUAL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | 319122-1205 (Utah) | Secondary |
207L00000X | Anesthesiology | G185046 (California) | Primary |
Entity Name | Mountain West Anesthesia Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1558391763 PECOS PAC ID: 9032018502 Enrollment ID: O20040103000057 |
Mailing Address | Practice Location Address |
---|---|
Glen Bowman, MD Po Box 33285, Los Gatos, CA 95031-3285 Ph: (408) 354-9254 | Glen Bowman, MD 1900 Sullivan Ave, Daly City, CA 94015-2200 Ph: (408) 354-9254 |
Dr. Richard Derby Jr., MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 901 Campus Drive, Suite 312, Daly City, CA 94015 Phone: 650-755-0733 Fax: 650-755-3018 | |
Sunil K Rohira, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 901 Campus Dr, Suite 102, Daly City, CA 94015 Phone: 650-991-2000 Fax: 650-755-8638 | |
Ronald D Friedman, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1900 Sullivan Ave, Daly City, CA 94015 Phone: 650-992-4000 | |
Jeffrey Michael Gaynor, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1900 Sullivan Ave, Daly City, CA 94015 Phone: 650-992-4000 | |
Michael Welby Bigelow, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1900 Sullivan Ave, Daly City, CA 94015 Phone: 650-992-4000 | |
Adam Dziuba, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1900 Sullivan Ave, Daly City, CA 94015 Phone: 650-992-4000 | |
Dr. Jackie Phan, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1900 Sullivan Ave, Daly City, CA 94015 Phone: 650-991-6816 |