Individual
PETER WILLIAM DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
136 N 3RD ST, LOMPOC, CA 93436-7002
(805) 736-1253
(805) 736-3193
Mailing address
PO BOX 2700, LOMPOC, CA 93438-2700
(805) 736-1253
(805) 736-3193
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
39619
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32415000
—
WI
05
—
ZZZ37313Z
—
CA
Enumeration date
08/16/2006
Last updated
03/07/2023
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