Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | A88990 | CA |
NPI | 1144343146 |
---|---|
Provider Name | Dr. Joshua Michael Ian Davidson |
First Address | Torrance, CA 90505-4971 |
Second Address | Torrance, CA 90505-4971 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2007 |
Last Update Date | 13/11/2013 |