MEDICARE: MATTHEW DAVIS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	G74673	CA

General Provider Information

NPI Number	:	1134148133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW DAVIS MD

Provider Business Mailing Address
First Line	:	PO BOX 35380
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-5380
Country	:	US
Telephone Number	:	702-579-3203
Fax Number	:

Provider Business Practice Location Address
First Line	:	10601 WALKER ST
Second Line	:	SUITE 250
City	:	CYPRESS
State	:	CA
Zip	:	90630-4733
Country	:	US
Telephone Number	:	714-252-8311
Fax Number	:	714-252-8339

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	11/15/2025

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