Individual
JUSTIN LANE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
8700 BEVERLY BLVD, WEST HOLLYWOOD, CA 90048-1804
(310) 423-8780
Mailing address
4140 W 190TH ST STE 306, TORRANCE, CA 90504-5513
(310) 423-8780
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
20A18362
CA
207P00000X
Emergency Medicine Physician
Primary
6152
OK
Other
Enumeration date
06/30/2016
Last updated
03/19/2024
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