Davalos, Ricardo
Davalos, Ricardo is an individual health care provider with primary practice located at 150 Avenida Cabrillo Suite #A, San Clemente CA 92627. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Davalos, Ricardo can be contacted via phone (949) 369-6993.Contact Information
Primary practice address
150 Avenida Cabrillo Suite #A
San Clemente CA 92627
Phone: (949) 369-6993
Fax: (949) 369-6469
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | A65157 | California |
Profile Details
| NPI number | 1609804749 |
|---|---|
| LBN Legal business name | Davalos, Ricardo |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 29th, 2006 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609804749 | NPPES |
| California | Other | A65157 | STATE LIC |
| California | MEDICAID | 00A651570 | STATE LIC |
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