Healthcare Provider Details

I. General information

NPI: 1386128643
Provider Name (Legal Business Name): ERIC AUSTIN DAVIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2018
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20642 JOHN DR
CASTRO VALLEY CA
94546-5103
US

IV. Provider business mailing address

20642 JOHN DR
CASTRO VALLEY CA
94546-5103
US

V. Phone/Fax

Practice location:
  • Phone: 510-581-2559
  • Fax:
Mailing address:
  • Phone: 510-581-2559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA185850
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number239820
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: