Individual
DR. JADE NGOC MY DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
343 S BROADWAY, LOS ANGELES, CA 90013-1207
(213) 626-9978
(213) 628-0500
Mailing address
343 S BROADWAY, LOS ANGELES, CA 90013-1207
(213) 626-9978
(213) 628-0500
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11765T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0117650
—
CA
Enumeration date
05/17/2006
Last updated
07/08/2007
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