Provider Demographics
NPI:1932512720
Name:MAYES, DAVIER DAVON (RVS)
Entity Type:Individual
Prefix:
First Name:DAVIER
Middle Name:DAVON
Last Name:MAYES
Suffix:
Gender:M
Credentials:RVS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2334 10TH ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94710-2355
Mailing Address - Country:US
Mailing Address - Phone:619-206-5662
Mailing Address - Fax:
Practice Address - Street 1:2334 10TH ST
Practice Address - Street 2:UNIT 1
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94710-2355
Practice Address - Country:US
Practice Address - Phone:619-206-5662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-09
Last Update Date:2017-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00078027246XC2903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XC2903XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularVascular Specialist