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General NPI Number Information
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NPI Number | 1972879385
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Entity Type | Individual
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Provider Name | SEAN ERIC DAVIS LAC
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Gender | Male
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Dates
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Enumeration Date | 03/29/2012
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Last Update Date | 06/08/2012
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Provider Practice Location Address
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Address Line | 5465 MOREHOUSE DR STE 100
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City | SAN DIEGO
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State | CA
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Zip | 92121-4713
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Country | US
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Telephone | 858-255-8070
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Fax | 858-750-2428
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Provider Business Mailing Address
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Address Line | 5465 MOREHOUSE DR STE 100
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City | SAN DIEGO
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State | CA
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Zip | 92121-4713
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Country | US
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Telephone | 858-255-8070
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Fax | 858-750-2428
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 14401
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License Number State | CA
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