Davidson, Jerome Gary

Davidson, Jerome Gary is an individual health care provider with primary practice located at 18300 Roscoe Blvd , Northridge CA 91325-4105. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Davidson, Jerome Gary can be contacted via phone (818) 700-2336.

Contact Information

Primary practice address
18300 Roscoe Blvd Northridge CA 91325-4105
Phone: (818) 700-2336
Fax: (818) 700-2337
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X A22489 California

Profile Details

NPI number 1114926490
LBN Legal business name Davidson, Jerome Gary
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2005
Last updated Jun 8th, 2011 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114926490 NPPES
California MEDICAID OOA224890
California MEDICAID 1114926490
California MEDICAID 1902108293

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