CORY STEPHEN DAVENPORT (NPI# 1730337858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730337858 |
| Entity Type | Individual |
| Full Name | CORY STEPHEN DAVENPORT |
| Credential | PA-C |
| Practice Address |
530 W Acacia St Ste 23 Stockton CA 95203-2454 |
| Mailing Address |
7259 S Bingham Junction Blvd Midvale UT 84047-4860 |
| Practice Telephone | 2092427098 |
| Practice Fax Number | 2094617579 |
| Mailing Telephone | 8666155536 |
| Mailing Fax Number | 8665884301 |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2018-04-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
55215 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
530 W ACACIA ST STE 23 |
| City | STOCKTON |
| State | CA |
| Zip Code | 95203-2454 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447899349 | Sagrario Alva Chavez | Technician | Sagrario Chavez, 1248 West Park St., Stockton, CA 95203 | 2019-12-26 |
| 1538682810 | Kumars Transport | Non-emergency Medical Transport (VAN) | 1112 W Fremont St, Stockton, CA 95203 | 2017-07-19 |
| 1194251595 | Jesmond Ridge Medical Services A Medical Corporation | Emergency Medicine | 525 W Acacla St, Stockton, CA 95203 | 2017-05-04 |
| 1285011064 | Brian Andrew Reuter | Emergency Medicine | Dameron Hospital, 525 Acacia St, Stockton, CA 95203 | 2015-04-30 |
| 1548209240 | Aaron James Simko | Pediatrics | 525 Acacia Street, Neonatal Department, Stockton, CA 95203 | 2006-06-06 |
| 1881057461 | El Concilio | Case Management | 445 N San Joaquin St, Stockton, CA 95203 | 2016-04-01 |
| 1619350634 | Sudha Vani Saduvala | Internal Medicine | 525 W Acacia St, Stockton, CA 95203 | 2015-07-08 |
| 1740621671 | Syed Salman Ali | Internal Medicine | 525 W Acacia St, Stockton, CA 95203 | 2013-07-08 |
| 1417021726 | Sahir Naseer | Emergency Medicine | 525 W Acacia St, Stockton, CA 95203 | 2006-11-20 |
| 1104312800 | Melissa Delossantos | Behavioral Analyst | 2180 Lucerne Ave, Stockton, CA 95203-1257 | 2018-07-05 |
| Find all providers in zip 95203 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841381472 | Kathryn D. Olson | Physician Assistant | 1800 N California St, Stockton, CA 95204-6019 | 2006-09-27 |
| 1710932967 | Vanessa D Ferrario | Physician Assistant | 2488 N California St, Alpine Orthopaedic Medical Group Inc, Stockton, CA 95204-5508 | 2006-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649894403 | Kathlyn Larco | Physician Assistant | 1233 W Randall Way, West Covina, CA 91790-4747 | 2020-06-07 |
| 1487126421 | Eliza Hughes | Physician Assistant | 860 Oak Park Blvd Ste 101, Arroyo Grande, CA 93420-1800 | 2018-12-31 |
| 1508333873 | Andrew Cantos Malit | Physician Assistant | 409 Bristol Way, Corona, CA 92879-6156 | 2018-10-25 |
| 1578049458 | Ida Jelveh | Physician Assistant | 28096 Edelweiss Ct, Laguna Niguel, CA 92677-7006 | 2018-07-13 |
| 1356833578 | Michael James Gonzalez | Physician Assistant | 1500 E Chevy Chase Dr # 401a401b, Glendale, CA 91206-4152 | 2018-06-04 |
| 1023500592 | Pamela Lambert Pa-c, Inc. | Physician Assistant | 16105 Mariposa Ave, Riverside, CA 92504-8730 | 2018-05-31 |
| 1225532385 | Folsom Physicain Assistant First Assist, Inc | Physician Assistant | Nina Vasiliev Pa-c, 15407 Muller Rd, Plymouth, CA 95669-9770 | 2018-03-22 |
| 1275040008 | Gm Surgical Assistant Inc | Physician Assistant | 15615 Turnberry St, Moreno Valley, CA 92555-4901 | 2018-01-02 |
| 1902311186 | Or Solutions Inc | Physician Assistant | 1501 Secret Ravine Pkwy Unit 527, Roseville, CA 95661-6005 | 2017-12-09 |
| 1184143828 | Alaa Abdalla Daghlas | Physician Assistant | 1100 S Eliseo Dr Ste A, Greenbrae, CA 94904-2017 | 2017-09-13 |
| Find all providers with the same taxonomy | ||||
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| 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.