Provider Demographics
NPI:1063435675
Name:DAVIS, STEVEN E (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:E
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3098
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90510-3098
Mailing Address - Country:US
Mailing Address - Phone:310-792-3914
Mailing Address - Fax:855-898-4055
Practice Address - Street 1:20911 EARL ST
Practice Address - Street 2:SUITE #470
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4352
Practice Address - Country:US
Practice Address - Phone:310-372-0700
Practice Address - Fax:310-372-0774
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA75984207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW19346Medicare ID - Type UnspecifiedMEDICARE NUMBER
CAY45530Medicare UPIN