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Individual

MICHAEL J DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
301 W HUNTINGTON DR, STE 107, ARCADIA, CA 91007-3462
(626) 574-0020
(626) 574-7188
Mailing address
301 W HUNTINGTON DR, STE 107, ARCADIA, CA 91007-3462
(626) 574-0020
(626) 574-7188

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
036120010
IL
207W00000X
Ophthalmology Physician
A111866
CA
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
A111866
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036120010 1
IL
Enumeration date
03/14/2008
Last updated
08/07/2020
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