Individual
DR. DANTAE D. DAVIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2650 JONES WAY, STE 8, SIMI VALLEY, CA 93065-1217
(805) 577-7977
(805) 577-0745
Mailing address
2650 JONES WAY, STE 8, SIMI VALLEY, CA 93065-1217
(805) 577-7977
(805) 577-0745
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G28898
CA
208600000X
Surgery Physician
G28898
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G288980
—
CA
Enumeration date
10/17/2006
Last updated
03/12/2020
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