Individual
MR. MICHAEL E DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
477 N EL CAMINO REAL, SUITE B301, ENCINITAS, CA 92024-1328
(760) 753-1104
(760) 436-2075
Mailing address
477 N EL CAMINO REAL, SUITE B301, ENCINITAS, CA 92024-1328
(760) 753-1104
(760) 436-2075
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA17532
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G448720
—
CA
Enumeration date
08/23/2006
Last updated
06/17/2011
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