Davidson, Jonathan Sam

Davidson, Jonathan Sam is an sole proprietor health care provider with primary practice located at 4206 Technology Dr Ste 2 , Modesto CA 95356-8769. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Gastroenterology, Allopathic & Osteopathic Physicians / Sleep Medicine. Allopathic & Osteopathic Physicians / Gastroenterology is his primary health care specialty. Davidson, Jonathan Sam can be contacted via phone (209) 492-0735.

Contact Information

Primary practice address
4206 Technology Dr Ste 2 Modesto CA 95356-8769
Phone: (209) 492-0735
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X G66389 California
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X G66389 California
Allopathic & Osteopathic Physicians / Sleep Medicine 207RS0012X G66389 California

Profile Details

NPI number 1295891224
LBN Legal business name Davidson, Jonathan Sam
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 27th, 2006
Last updated Aug 12th, 2013 - about 11 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 1295891224 NPPES
California MEDICAID 1295891224

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