Provider Demographics
NPI:1699770511
Name:DAVIES, JAMES A (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:DAVIES
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 1:2124 S EL CAMINO REAL STE 100
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-6211
Mailing Address - Country:US
Mailing Address - Phone:760-729-7101
Mailing Address - Fax:760-729-7106
Practice Address - Street 1:2124 S EL CAMINO REAL STE 100
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-6211
Practice Address - Country:US
Practice Address - Phone:760-729-7101
Practice Address - Fax:760-729-7106
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC41798207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWC41798AMedicare PIN