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NPI Code Detail

MEDICARE: DR. RONNIE T DAVIS JR. DC, CCSP

MEDICARE: DR. RONNIE T DAVIS JR. DC, CCSP
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
1111N00000XChiropractor35191CA

General Provider Information

NPI Number : 1598603912
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RONNIE T DAVIS JR. DC, CCSP
Provider Business Mailing Address
First Line : 614 GALEN DR
Second Line :
City : SAN JOSE
State : CA
Zip : 95123-4841
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4675 STEVENS CREEK BLVD STE 121
Second Line :
City : SANTA CLARA
State : CA
Zip : 95051-6763
Country : US
Telephone Number : 408-394-0288
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2026
Last Update Date : 03/24/2026

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