Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | G68422 | CA |
NPI | 1124080593 |
---|---|
Provider Name | Jon Robert Davids |
First Address | Sacramento, CA 95817 |
Second Address | Sacramento, CA 95817 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2006 |
Last Update Date | 13/08/2018 |