Provider Demographics
NPI:1225197056
Name:DAVIS, DONALD L (DC)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:L
Last Name:DAVIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9911 W PICO BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-2703
Mailing Address - Country:US
Mailing Address - Phone:310-203-0500
Mailing Address - Fax:310-203-0508
Practice Address - Street 1:9911 W PICO BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-2703
Practice Address - Country:US
Practice Address - Phone:310-203-0500
Practice Address - Fax:310-203-0508
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CADC29957111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor