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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DOUGLAS PETER DAVIDSON JR., PA

Deactivated

DOUGLAS PETER DAVIDSON JR., PA is a Physician Assistant healthcare provider located in SAN RAFAEL, California. NPI 1174294938 is deactivated in the NPPES registry. Verify at CMS.

Physician Assistant · SAN RAFAEL, CA

This NPI has been deactivated. The record was deactivated on February 26, 2022. Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated. Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.

Registration Details

NPI Number
1174294938
Provider Type
Individual
Gender
Male
NPI Issued
Sep 22, 2021 (0.43013698630137 yrs)
Last Updated
Mar 7, 2023
Deactivated
Feb 26, 2022
License
62399 (CA)

Practice Information

Address
50 ACACIA AVE
SAN RAFAEL, CA, 949012230
Browse CA providers · Browse ZIP 94901
Phone
9518168970
Primary Specialty
Physician Assistant
363A00000X
Additional Specialty
Physician Assistant

Other Physician Assistant Providers in SAN RAFAEL, CA

Name Credential NPI
MS. VERONICA A GONZALES PA 1245329606
YVONNE LIN SORENSON PA-C 1467658245
ROSE MARY JACQUELIN ALBUJAR PA-C 1659563849
ROBERT E BELL JR. PA 1255671186
MIGUEL SERRATO ATC OT-C 1013321264
SHEILA SAHAR MOIN PA-C 1760832521
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.