MEDICARE: DR. DONALD L DAVIS D.C.

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	111N00000X	Chiropractor	DC29957	CA

General Provider Information

NPI Number	:	1225197056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD L DAVIS D.C.

Provider Business Mailing Address
First Line	:	9911 W PICO BLVD
Second Line	:	SUITE 101
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-2703
Country	:	US
Telephone Number	:	310-203-0500
Fax Number	:	310-203-0508

Provider Business Practice Location Address
First Line	:	9911 W PICO BLVD
Second Line	:	SUITE 101
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-2703
Country	:	US
Telephone Number	:	310-203-0500
Fax Number	:	310-203-0508

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

Provider Enumeration Date	:	12/07/2006
Last Update Date	:	04/07/2011

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