Davis, Dave

Davis, Dave is an sole proprietor health care provider with primary practice located at 2180 Johnson Ave , San Luis Obispo CA 93401-4558. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Davis, Dave can be contacted via phone (805) 781-4753.

Contact Information

Primary practice address
2180 Johnson Ave San Luis Obispo CA 93401-4558
Phone: (805) 781-4753
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X California

Profile Details

NPI number 1073762209
LBN Legal business name Davis, Dave
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 11th, 2008
Last updated Jul 2nd, 2019 - about 7 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 1073762209 NPPES
California MEDICAID 4006

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