Individual
MR. MICHAEL JAMES DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11406 LOMA LINDA DR, LOMA LINDA, CA 92354-3711
(909) 558-4000
Mailing address
PO BOX 1859, SACRAMENTO, CA 95812-1859
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
CPO1263
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
XC0012630
—
CA
Enumeration date
12/10/2008
Last updated
12/10/2008
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