Healthcare Provider Details

I. General information

NPI: 1740215763
Provider Name (Legal Business Name): MICHAEL EVAN DAVIES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 TRUXTUN AVE STE 200
BAKERSFIELD CA
93309-0656
US

IV. Provider business mailing address

4100 TRUXTUN AVE STE 200
BAKERSFIELD CA
93309-0656
US

V. Phone/Fax

Practice location:
  • Phone: 661-632-1540
  • Fax: 661-632-1538
Mailing address:
  • Phone: 661-632-1540
  • Fax: 661-632-1538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberA31892
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: