Active NPI
Muntu Ramel Davis, M.D.
- Family Medicine Physician
- Oakland, CA
National Provider Identifier
1104017540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A74787
- Practice address
- 1000 Broadway
Fifth Floor
Oakland, CA 94607-4099 - Phone
- (510) 267-8000
- NPI assigned
- Aug 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A74787 | CA | Primary |
Addresses
Primary practice location
1000 Broadway
Fifth Floor
Oakland, CA 94607-4099
Mailing address
1000 Broadway
Fifth Floor
Oakland, CA 94607-4099
Phone (510) 267-8000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74787 | CA | MD | Pharmacist |
| A74787 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186531200000",
"number": "1104017540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 BROADWAY",
"address_2": "FIFTH FLOOR",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946074099",
"telephone_number": "510-267-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 BROADWAY",
"address_2": "FIFTH FLOOR",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946074099",
"telephone_number": "510-267-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "MUNTU",
"middle_name": "RAMEL",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-08",
"last_updated": "2007-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A74787",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.