Provider Demographics
NPI:1003915646
Name:DAVIS, I. JEAN ROBINSON (PHD, DC, PA)
Entity Type:Individual
Prefix:
First Name:I. JEAN
Middle Name:ROBINSON
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PHD, DC, PA
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Mailing Address - Street 1:5800 SEA WALK DR
Mailing Address - Street 2:UNIT #2
Mailing Address - City:PLAYA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:90094-2140
Mailing Address - Country:US
Mailing Address - Phone:310-745-8446
Mailing Address - Fax:310-745-8449
Practice Address - Street 1:9200 COLIMA RD STE 106
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605
Practice Address - Country:US
Practice Address - Phone:526-693-2654
Practice Address - Fax:562-693-2554
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2018-07-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA10293363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant