MEDICARE: TIMOTHY T 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
1	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	A63742	CA

General Provider Information

NPI Number	:	1770515603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY T DAVIS M.D.

Provider Business Mailing Address
First Line	:	1112 MONTANA AVE # 900
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-1652
Country	:	US
Telephone Number	:	310-574-2777
Fax Number	:	310-315-4968

Provider Business Practice Location Address
First Line	:	2801 WILSHIRE BLVD STE A
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-4801
Country	:	US
Telephone Number	:	310-574-2777
Fax Number	:	310-315-4968

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

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	05/01/2026

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