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Individual

MR. GREGORY DAVID DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.-C.

Contact information

Practice address
4300 BIRCH AVE, LAKE ISABELLA, CA 93240-1628
(760) 379-1791
(760) 379-1793
Mailing address
PO BOX 1628, LAKE ISABELLA, CA 93240-1628
(760) 379-1791
(760) 379-1793

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA 13448
CA

Other

Enumeration date
11/07/2006
Last updated
07/08/2007
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