Davidson, Jerry A

Davidson, Jerry A is an sole proprietor health care provider with primary practice located at 2876 Sycamore Dr Suite 101, Simi Valley CA 93065-1550. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Davidson, Jerry A can be contacted via phone (805) 527-6424.

Contact Information

Primary practice address
2876 Sycamore Dr Suite 101 Simi Valley CA 93065-1550
Phone: (805) 527-6424
Fax: (805) 522-0115
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X G33458 California

Profile Details

NPI number 1922073998
LBN Legal business name Davidson, Jerry A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 22nd, 2006
Last updated Apr 19th, 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 1922073998 NPPES
California MEDICAID 00G334580

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