MEDICARE: CONSTANCE J DAVIS-HUEGEL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1356129605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONSTANCE J DAVIS-HUEGEL

Provider Business Mailing Address
First Line	:	1362 TEMPLE AVE APT 206
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90804-2446
Country	:	US
Telephone Number	:	562-706-0317
Fax Number	:

Provider Business Practice Location Address
First Line	:	1362 TEMPLE AVE APT 206
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90804-2446
Country	:	US
Telephone Number	:	562-706-0317
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/18/2023
Last Update Date	:	09/18/2023

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Directions to “ CONSTANCE J DAVIS-HUEGEL ” Practice Location

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