QUEEN MARY DAVIS (NPI# 1356588123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356588123 |
| Entity Type | Individual |
| Full Name | QUEEN MARY DAVIS |
| Credential | REGISTERED NURSE |
| Practice Address |
1807 S Genesee Ave Los Angeles CA 90019-5032 |
| Practice Telephone | 3239339014 |
| Practice Fax Number | 3239371872 |
| Mailing Telephone | 3239339014 |
| Mailing Fax Number | 3239371872 |
| Enumeration Date | 2009-01-14 |
| Last Update Date | 2009-01-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 172A00000X | Driver | CA #0367076 | CA | Other Service Providers |
| N | 172V00000X | Community Health Worker | CA# 0367076 | CA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DEPARTMENT OF MOTOR VEHICLES- MOTOR CARRIER | CA# 0367076 | 01 |
| CA | INDIVIDUAL & FAMILY SOCIAL SERVICE | SIC 8322 | 01 |
| CALIFORNIA SMALL BUSINESS CERTIFICATION | 0055719 | 01 | |
| CA | FICTITIOUS BUSINESS NAME STATEMENT | 20080702766 | 01 |
| REGISTERED LOS ANGELES COUNTY VENDOR | 0055719 | 01 | |
| CA | SERVICE FOR ELDERLY AND PERSONS WITH DISABILITIES | NAICS 624120 | 01 |
| Street Address |
1807 S GENESEE AVE |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90019-5032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386299139 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 1302 South La Brea, Los Angeles, CA 90019 | 2019-08-08 |
| 1104383694 | 310 Recovery Inc. | Clinic/Center | 1723 1/2 Hauser Blvd, Los Angeles, CA 90019 | 2019-02-21 |
| 1184131328 | Sehyeong Son | Acupuncturist | 1722 Crenshaw Blvd, Los Angeles, CA 90019 | 2018-01-09 |
| 1285158154 | Vanessa A. Myrie | Social Worker | 5562 Packard St., Los Angeles, CA 90019 | 2017-08-01 |
| 1093241309 | Hamburger Home | Community/Behavioral Health | 4066 W. 17th Street, Los Angeles, CA 90019 | 2017-05-05 |
| 1639614779 | Jung Ho Kang | Acupuncturist | 903 S. Crenshaw Blvd #304a, Los Angeles, CA 90019 | 2016-12-28 |
| 1912353491 | Sung Won Lee | Acupuncturist | 4027 W. Pico Bl., Los Angeles, CA 90019 | 2016-05-13 |
| 1497188528 | Sfvcmhc | Community/Behavioral Health | 5754 San Vicente Blvd, 401, Los Angeles, CALIFORNIA 90019 | 2013-08-13 |
| 1467890160 | Denise Breheny | Lactation Consultant, Non-RN | 1053 Carmona Ave., Los Angeles, CA 90019 | 2013-06-05 |
| 1336483122 | Nancy Denise - Latten Davidson | Student in an Organized Health Care Education/Training Program | 4073-75 West Pico Blvd, Los Angeles, CA 90019 | 2012-11-16 |
| Find all providers in zip 90019 | ||||
| Taxonomy Code | 172A00000X |
| Grouping | Other Service Providers |
| Classification | Driver |
| A person employed to operate a motor vehicle as a carrier of persons or property. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427668672 | Se Hoon Cho | Driver | 2268 W 20th St #2, Los Angeles, CA 90018-1412 | 2020-08-03 |
| 1134764806 | Tony's Limousine Service, Inc. | Driver | 11648 Mayfield Ave Apt 301, Los Angeles, CA 90049-5777 | 2019-11-16 |
| 1427544857 | Rori Bergeron | Driver | 4198 Sutro Ave, Los Angeles, CA 90008-3923 | 2018-07-09 |
| 1043749435 | Tamika Brown | Driver | 2947 Van Buren Place, Los Angeles, CA 90007 | 2017-06-08 |
| 1730631656 | Narek Harutyunyan | Driver | 6051 Hollywood Blvd Ste 205, Los Angeles, CA 90028-5496 | 2016-10-26 |
| 1740731314 | Ronald Robbins | Driver | 1850 Whitley Ave, Suite 301, Los Angeles, CA 90028-4968 | 2016-10-19 |
| 1184093007 | Carlos Anibal Padilla Jr. | Driver | 337 W 131st St, Los Angeles, CA 90061-1103 | 2015-09-22 |
| 1003201542 | Beleshia Nygea Lopez | Driver | 3910 3rd Ave, Los Angeles, CA 90008-2706 | 2015-04-01 |
| 1821480633 | Karina Cruz | Driver | 2134 W Sunset Blvd Ste 128, Los Angeles, CA 90026-3192 | 2015-03-03 |
| 1003165143 | David Charles Leidner | Driver | 1308 Factory Pl, #404, Los Angeles, CA 90013-2252 | 2012-09-05 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90019 |
Please comment or provide details below to improve the information on QUEEN MARY DAVIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.