Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | DC13494 | CA |
NPI | 1689756322 |
---|---|
Provider Name | Dr. Don Gregory Davis |
First Address | Walnut Creek, CA 94596-7208 |
Second Address | Walnut Creek, CA 94596-7208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 07/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T05042 | (02) | CA |