Individual
DARRYL LAMONT DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
200 MERCY CR, CAMP PENDLTON, CA 92055
(951) 308-2200
Mailing address
3406A DALY ST, TWENTYNINE PALMS, CA 92277-9467
(760) 830-6065
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
54451
CA
363AM0700X
Medical Physician Assistant
Primary
54451
CA
Other
Enumeration date
07/23/2008
Last updated
03/11/2025
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