Individual
DOUGLAS PETER DAVIDSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
50 ACACIA AVE, SAN RAFAEL, CA 94901-2230
(951) 816-8970
Mailing address
38332 MAPLE CT, MURRIETA, CA 92562-3406
(951) 816-8970
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
62399
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/22/2021
Last updated
03/07/2023
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