Provider Demographics
NPI:1720480031
Name:JONATHAN JAMES DAVIES
Entity Type:Organization
Organization Name:JONATHAN JAMES DAVIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MACRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:OFF
Authorized Official - Phone:408-984-2455
Mailing Address - Street 1:3234 MCKINLEY DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-6765
Mailing Address - Country:US
Mailing Address - Phone:408-984-2455
Mailing Address - Fax:408-984-2456
Practice Address - Street 1:3234 MCKINLEY DR
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-6765
Practice Address - Country:US
Practice Address - Phone:408-984-2455
Practice Address - Fax:408-984-2456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA51498363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty