Jennifer Lise Davis, MD
General Practice in San Diego, CA. Individual provider (NPI-1).
NPI number1720175862
StatusActive
Last updated in NPPESApr 17, 2024
Details
- NPI
- 1720175862
- Entity type
- Individual (NPI-1)
- Name
- Jennifer Lise Davis
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 9, 2006
- Certification date
- Mar 6, 2024
- Last updated
- Apr 17, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | A101027 | CA | Yes |
Practice location
3160 Camino Del Rio S Ste 315San Diego, CA 92108-3835
Phone 619-377-9909 · Fax 619-378-6596
Mailing address
3160 Camino Del Rio S Ste 315San Diego, CA 92108-3835
Phone 619-377-9909 · Fax 619-378-6596
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