Healthcare Provider Details

I. General information

NPI: 1396374641
Provider Name (Legal Business Name): JUAN FELIPE DAVILA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2020
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 QUALITY DR
VACAVILLE CA
95688-9494
US

IV. Provider business mailing address

2705 13TH ST
SACRAMENTO CA
95818-2907
US

V. Phone/Fax

Practice location:
  • Phone: 707-624-4000
  • Fax:
Mailing address:
  • Phone: 724-223-3085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA208230
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: