Provider Demographics
NPI:1366734485
Name:POBRE, ROWENA Q
Entity type:Individual
Prefix:MS
First Name:ROWENA
Middle Name:Q
Last Name:POBRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 E 8TH ST
Mailing Address - Street 2:APT # 9
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950
Mailing Address - Country:US
Mailing Address - Phone:619-259-3310
Mailing Address - Fax:
Practice Address - Street 1:2424 E 8TH ST
Practice Address - Street 2:APT # 9
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-2938
Practice Address - Country:US
Practice Address - Phone:619-259-3310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-08
Last Update Date:2011-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA411142247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist