Healthcare Provider Details

I. General information

NPI: 1427475417
Provider Name (Legal Business Name): TARON RASHAD DAVIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2014
Last Update Date: 12/17/2019
Certification Date: 12/17/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 16TH ST FL 4
SAN FRANCISCO CA
94143-2549
US

IV. Provider business mailing address

550 16TH ST FL 4
SAN FRANCISCO CA
94143-2549
US

V. Phone/Fax

Practice location:
  • Phone: 415-502-2338
  • Fax:
Mailing address:
  • Phone: 415-502-2338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA163233
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License NumberA163233
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: