Provider Demographics
NPI:1013909225
Name:DAVIS, WILLIAM F (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:F
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 E 1ST ST
Mailing Address - Street 2:SUITE 270
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-4079
Mailing Address - Country:US
Mailing Address - Phone:714-542-6606
Mailing Address - Fax:714-542-6652
Practice Address - Street 1:2010 E 1ST ST
Practice Address - Street 2:SUITE 270
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-4079
Practice Address - Country:US
Practice Address - Phone:714-542-6606
Practice Address - Fax:714-542-6652
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG69230174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF82646Medicare UPIN