Provider Demographics
NPI:1912887332
Name:DAVALOS, MIGUEL ANGEL
Entity type:Individual
Prefix:
First Name:MIGUEL
Middle Name:ANGEL
Last Name:DAVALOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 E SAN JOAQUIN ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-2945
Mailing Address - Country:US
Mailing Address - Phone:831-597-3503
Mailing Address - Fax:831-998-8704
Practice Address - Street 1:30 E SAN JOAQUIN ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2945
Practice Address - Country:US
Practice Address - Phone:831-597-3503
Practice Address - Fax:831-998-8704
Is Sole Proprietor?:No
Enumeration Date:2025-09-05
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker