| Gary Davidson, PA | |
|
13652 Cantara St, Panorama City, CA 91402-5423 | |
| (818) 375-2000 | |
| Not Available |
| Full Name | Gary Davidson |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 13652 Cantara St, Panorama City, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104027093 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA20247 (California) | Primary |
| Entity Name | Southern California Permanente Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678 |
| Mailing Address | Practice Location Address |
|---|---|
| Gary Davidson, PA 13652 Cantara St, Panorama City, CA 91402-5423 Ph: (818) 375-2000 | Gary Davidson, PA 13652 Cantara St, Panorama City, CA 91402-5423 Ph: (818) 375-2000 |
Crespin Rodriguez, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 13652 Cantara St, Panorama City, CA 91402 Phone: 818-375-1690 |
Joseph L Sendrow, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 13652 Cantara St, Panorama City, CA 91402 Phone: 818-375-2000 |
Maria R Oculam, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 13652 Cantara St, Panorama City, CA 91402 Phone: 818-375-2000 |
Debra L Sortino, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 13652 Cantara St, Panorama City, CA 91402 Phone: 818-375-2000 |
Melissa Chao, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 8727 Van Nuys Blvd Ste 201, Panorama City, CA 91402 Phone: 818-479-7182 |
Theresa Nguyen, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 14860 Roscoe Blvd Ste 207, Panorama City, CA 91402 Phone: 707-638-5329 |
Jeremiah Chad Martinez, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 8727 Van Nuys Blvd Ste 105, Panorama City, CA 91402 Phone: 818-528-6949 |