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NPI Code Detail

MEDICARE: DR. SHELDON JEROME DAVIDSON MD

MEDICARE: DR. SHELDON JEROME DAVIDSON MD
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
1207RH0003XHematology & Oncology PhysicianG15884CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457350738
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHELDON JEROME DAVIDSON MD
Provider Business Mailing Address
First Line : PO BOX 11307
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92423-1307
Country : US
Telephone Number : 818-700-2336
Fax Number : 818-700-2337
Provider Business Practice Location Address
First Line : 18300 ROSCOE BLVD
Second Line :
City : NORTHRIDGE
State : CA
Zip : 91325-4105
Country : US
Telephone Number : 818-700-2336
Fax Number : 818-700-2337
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2005
Last Update Date : 06/08/2011

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