Individual
MICHAEL STEVEN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 COTTAGE AVE, STE 203, MANTECA, CA 95336-4935
(209) 825-5864
(209) 825-2632
Mailing address
200 COTTAGE AVE, STE 203, MANTECA, CA 95336-4935
(209) 825-5864
(209) 825-2632
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
A41457
CA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
A41457
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A414570
MEDICARE PTAN
CA
Enumeration date
05/31/2005
Last updated
11/23/2009
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