Provider Demographics
NPI:1053600940
Name:DAVIS, JASON AARON (MD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:AARON
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:17525 VENTURA BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-5111
Mailing Address - Country:US
Mailing Address - Phone:818-986-2861
Mailing Address - Fax:818-638-5762
Practice Address - Street 1:3828 E IMPERIAL HWY STE 300
Practice Address - Street 2:
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262
Practice Address - Country:US
Practice Address - Phone:310-900-4788
Practice Address - Fax:310-900-2704
Is Sole Proprietor?:No
Enumeration Date:2011-03-31
Last Update Date:2022-05-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA116229207X00000X, 207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery