MEDICARE: KEITH ROBERT DAVIS IDC

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	1710I1003X	Independent Duty Medical Technicians

General Provider Information

NPI Number	:	1689873192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEITH ROBERT DAVIS IDC

Provider Business Mailing Address
First Line	:	140 SYLVESTER RD
Second Line	:	USS TOPEKA (SSN 754) FPO AP 96679-2410
City	:	SAN DIEGO
State	:	CA
Zip	:	92106-3521
Country	:	US
Telephone Number	:	619-553-0123
Fax Number	:	619-553-0744

Provider Business Practice Location Address
First Line	:	140 SYLVESTER RD
Second Line	:	USS TOPEKA (SSN 754) FPO AP 96679-2410
City	:	SAN DIEGO
State	:	CA
Zip	:	92106-3521
Country	:	US
Telephone Number	:	619-553-0123
Fax Number	:	619-553-0744

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

Provider Enumeration Date	:	07/13/2007
Last Update Date	:	07/13/2007

Similar Medicare Providers

1881914000 — GRUPO MEDICO POLICLINICA SAN PEDRO MEDICARE ADVANTAGE
Practice Location Address:

211 CALLE MORSE
ARROYO, PR
00714-2350

Practice Phone: 787-839-3980
Practice Fax: 787-271-2515

1255302188 — MR. JAMES ALEXANDER MANNIS LCSW
Practice Location Address:

140 SYLVESTER RD , SARP BLDG 500, RM 601
SAN DIEGO, CA
92106-3521

Practice Phone: 619-553-0535
Practice Fax:

1023085883 — MR. ANTHONY PETRONE JR. MA
Practice Location Address:

140 SYLVESTER RD
SAN DIEGO, CA
92106-3521

Practice Phone: 619-553-8719
Practice Fax: 619-553-7758

1871560284 — MR. ALLEN JAMES LAHEIST IDC
Practice Location Address:

140 SYLVESTER RD
SAN DIEGO, CA
92106-3521

Practice Phone: 619-553-0838
Practice Fax:

1750490645 — NICOLE MARIE LANOUETTE MD
Practice Location Address:

140 SYLVESTER RD BLDG 500
SAN DIEGO, CA
92106-3521

Practice Phone: 619-553-0276
Practice Fax: 619-553-9448

1376751917 — MICHAEL CLARK
Practice Location Address:

140 SYLVESTER RD
SAN DIEGO, CA
92106-3521

Practice Phone: 619-553-8719
Practice Fax:

Directions to “ KEITH ROBERT DAVIS IDC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.