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Benjamin Ray Davis, PA
Medical Physician Assistant in Orange, California
NPI 1609247477

Benjamin Ray Davis is a Medical Physician Assistant based in Orange, CA and is specialized in Medical. Benjamin Ray Davis practices in Orange, CA and has the professional credentials of PA. The NPI Number for Benjamin Ray Davis is 1609247477 and holds a License No. 52963 (California).

The current practice location address for Benjamin Ray Davis is 1010 W La Veta Ave Ste 750, Orange, CA and can be reached out via phone at 714-639-9401.

Location: 1010 W La Veta Ave Ste 750, Orange, CA, 92868-4312
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Provider Profile Details
NPI Number
1609247477
Provider Name
Benjamin Ray Davis
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
1010 W La Veta Ave Ste 750, Orange, CA, 92868-4312
Phone Number
714-639-9401
Fax Number
Provider Enumeration Date
10/19/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
GRP. NPI: 1912919804 01 CA MEDI-CAL
1912919804 01 CA TYPE 2 NPI
52963 01 CA MEDICAL LICENSE
institution
Provider Business Practice Location Address Details
Address
1010 W La Veta Ave Ste 750
City
State
Zip
92868-4312
Phone Number
714-639-9401
Fax Number
person
Provider Business Mailing Address Details
Address
1010 W La Veta Ave Ste 750
City
State
Zip
92868-4312
Phone Number
714-639-9401
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
52963 (California)
Definition
Definition to come...
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