Healthcare Provider Details
I. General information
NPI: 1841346442
Provider Name (Legal Business Name): HEATHER RACHEL DAVIDS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/26/2007
Last Update Date: 09/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2800 L ST STE 501
SACRAMENTO CA
95816-5616
US
IV. Provider business mailing address
10470 OLD PLACERVILLE RD STE 100
SACRAMENTO CA
95827-2539
US
V. Phone/Fax
- Phone: 916-454-6850
- Fax: 916-454-6852
- Phone: 800-470-0071
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208VP0000X |
| Taxonomy | Pain Medicine Physician |
| License Number | A106707 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: