Organization
DEAN L DAVIS MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEAN L DAVIS M.D. (OWNER)
(661) 872-2422
Entity
Organization
Contact information
Practice address
2215 TRUXTUN AVE, BAKERSFIELD, CA 93301-3602
(661) 872-2422
Mailing address
PO BOX 151, BAKERSFIELD, CA 93302-0151
(661) 872-2422
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G599070
MEDICARE PTAN
CA
Enumeration date
06/25/2010
Last updated
06/25/2010
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