Provider Demographics
NPI:1437529153
Name:JENNIFER L DAVIS, MD, INC
Entity Type:Organization
Organization Name:JENNIFER L DAVIS, MD, INC
Other - Org Name:POINT LOMA PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-222-1253
Mailing Address - Street 1:2790 TRUXTUN RD
Mailing Address - Street 2:SUITE 120A
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92106-6135
Mailing Address - Country:US
Mailing Address - Phone:619-222-1253
Mailing Address - Fax:619-222-1276
Practice Address - Street 1:2790 TRUXTUN RD
Practice Address - Street 2:SUITE 120A
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92106-6135
Practice Address - Country:US
Practice Address - Phone:619-222-1253
Practice Address - Fax:619-222-1276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-07
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty