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NPI Code Detail

MEDICARE: DR. DEAN LEROY DAVIS M.D.

MEDICARE: DR. DEAN LEROY DAVIS M.D.
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
12085R0001XRadiation Oncology PhysicianG59907CA

General Provider Information

NPI Number : 1619996139
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEAN LEROY DAVIS M.D.
Provider Business Mailing Address
First Line : PO BOX 151
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93302-0151
Country : US
Telephone Number : 661-632-5700
Fax Number : 661-632-5875
Provider Business Practice Location Address
First Line : 2215 TRUXTUN AVE
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93301-3602
Country : US
Telephone Number : 661-632-5700
Fax Number : 661-632-5878
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 07/08/2007

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