Healthcare Provider Details

I. General information

NPI: 1669362802
Provider Name (Legal Business Name): MR. HOWARD HUGH DAVIS III
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: TRE DAVIS

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 3RD ST STE 1C
SAN FRANCISCO CA
94124-1444
US

IV. Provider business mailing address

16 TURK ST
SAN FRANCISCO CA
94102-2808
US

V. Phone/Fax

Practice location:
  • Phone: 415-437-3990
  • Fax: 415-437-3994
Mailing address:
  • Phone: 478-233-5277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: