Calvin Travon Davis, PHYSICIAN ASSISTANT

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

15426 Issued in CA

Practice address

4580 Pacific Blvd. (Stacy Medical Center)
Vernon, CA 90058

Phone

(323) 584-0779

Fax

(323) 582-2282

NPI assigned

Oct 5, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1664928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1831814508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15632 HASKINS AVE.",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "90220",
            "telephone_number": "323-203-4678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4580 PACIFIC BLVD. (STACY MEDICAL CENTER)",
            "city": "VERNON",
            "state": "CA",
            "postal_code": "90058",
            "telephone_number": "323-584-0779",
            "fax_number": "323-582-2282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CALVIN",
        "middle_name": "TRAVON",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-05",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "15426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Central Occupational Medicine Providers - Ontario, a Medical Corporati
• Michael Chung Hou Chiang, M.D.
• City of Vernon
• Guilllermo Jose Covarrubias, P.T.A.
• Sean Cutrell, DPT
• Everytable, PBC
• Ian Fitz-Gibbon
• Steven Florman, MD
• Tomas Garcia Jr., PSYD
• Alejandro Hernandez, P.A.-C

• Medical Physician Assistant in Vernon, CA
• Providers in Vernon, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.