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General NPI Number Information
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NPI Number | 1861523029
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Entity Type | Organization
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Legal Business Name | ROBERT A DAVIS MD INC
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 06/28/2019
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Provider Practice Location Address
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Address Line | 3443 VILLA LN STE 10
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City | NAPA
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State | CA
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Zip | 94558-6417
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Country | US
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Telephone | 707-294-2203
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Fax | 707-252-9012
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Provider Business Mailing Address
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Address Line | 3443 VILLA LN STE 10
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City | NAPA
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State | CA
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Zip | 94558-6417
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Country | US
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Telephone | 707-294-2203
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Fax | 707-252-9012
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DEBORAH JUCHAU
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Credential |
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Telephone | 707-294-2203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G23265
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License Number State | CA
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