Darryl Lamont Davenport, PA-C is a medicare enrolled "Physician Assistant - Medical" in Camp Pendlton, California. His current practice location is
200 Mercy Cr, Camp Pendlton, California. You can reach out to his office (for appointments etc.) via phone at
(951) 308-2200.
Darryl Lamont Davenport is licensed to practice in California (license number 54451) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1396900965.
Provider's Profile
| Full Name | Darryl Lamont Davenport |
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| Gender | Male |
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| Speciality | Physician Assistant - Medical |
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| Location | 200 Mercy Cr, Camp Pendlton, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1396900965
- Provider Enumeration Date: 07/23/2008
- Last Update Date: 03/11/2025
Medicare PECOS Information:
- PECOS PAC ID: 7719250885
- Enrollment ID: I20170912001875
Medical Identifiers
Medical identifiers for Darryl Lamont Davenport such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1396900965 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 363A00000X | Physician Assistant | 54451 (California) | Secondary |
| 363AM0700X | Physician Assistant - Medical | 54451 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Darryl Lamont Davenport is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Darryl Lamont Davenport, PA-C 3406a Daly St, Twentynine Palms, CA 92277-9467 Ph: (760) 830-6065 | Darryl Lamont Davenport, PA-C 200 Mercy Cr, Camp Pendlton, CA 92055 Ph: (951) 308-2200 |
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