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General NPI Number Information
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NPI Number | 1669857488
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Entity Type | Individual
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Provider Name | CHRISTINE DAVIS
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Gender | Female
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Dates
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Enumeration Date | 07/22/2015
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 450 4TH AVE STE 301
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City | CHULA VISTA
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State | CA
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Zip | 91910-4429
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Country | US
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Telephone | 619-271-7824
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Fax |
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Provider Business Mailing Address
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Address Line | 450 4TH AVE STE 301
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City | CHULA VISTA
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State | CA
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Zip | 91910-4429
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Country | US
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Telephone | 619-271-7824
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 20A23287
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License Number State | CA
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