Provider Demographics
NPI:1366592248
Name:LOWE, ROBERT RAY JR (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:RAY
Last Name:LOWE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:551 FLORIDA ST
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:91932-1655
Mailing Address - Country:US
Mailing Address - Phone:619-424-9490
Mailing Address - Fax:
Practice Address - Street 1:3400 TARAWA RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92155-5002
Practice Address - Country:US
Practice Address - Phone:619-437-2601
Practice Address - Fax:619-437-5699
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS06745207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine