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General NPI Number Information
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NPI Number | 1407761489
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Entity Type | Organization
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Legal Business Name | JILLIAN DAVENPORT, MD, FAAP, INC.
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Dates
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Enumeration Date | 08/15/2026
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Last Update Date | 08/15/2026
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Provider Practice Location Address
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Address Line | 230 STATION WAY STE B
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City | ARROYO GRANDE
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State | CA
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Zip | 93420-3383
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Country | US
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Telephone | 805-473-3262
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Fax | 805-473-3707
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Provider Business Mailing Address
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Address Line | 230 STATION WAY STE B
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City | ARROYO GRANDE
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State | CA
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Zip | 93420-3383
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Country | US
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Telephone | 805-473-3262
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Fax | 805-473-3707
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Authorized Official
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Title or Position | OWNER
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Name | DR. JILLIAN DAVENPORT
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Credential | MD
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Telephone | 805-473-3262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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