Provider Information for 1053957126
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SARAH MICHELLE DAVIS
Sex: Female
NPI: 1053957126
Last Updated: 2024-05-10
Certification Date: 2024-05-10
Certification Date: 2024-05-10
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1053957126 | ||||||||||||
| Enumeration Date | 2019-11-22 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 815 COLORADO BLVD STE 300 LOS ANGELES, CA 90041-1744 United States Phone: 323-543-2800 | Fax:323-978-1263 | ||||||||||||
| Primary Practice Address | 1472 W BADILLO ST SAN DIMAS, CA 91773-3534 United States Phone: 626-710-3414 | Fax: | ||||||||||||
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