Individual
DAN K. DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1015 E MAIN ST, TURLOCK, CA 95380-3406
(209) 632-3901
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 524-1211
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G66190
CA
2085R0202X
Diagnostic Radiology Physician
G66190
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G661900
—
CA
Enumeration date
05/12/2006
Last updated
06/07/2010
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