Amanda Davenport

NPI 1366226474 · on the registry since 2023

Practice

Address: 2495 Truxtun Rd Ste 200
San Diego, CA 92106
Phone: (858) 755-5200
Fax: (619) 223-2307
Organisation at this address: Vons Companies Inc
1918 Winter Street Operating Co Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 16

Registry record

Primary taxonomy: 225100000X
225100000X
Licence states on file: CA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2023-08-21

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California