Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Douglas Peter Davidson Jr., PA

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1174294938

Douglas Peter Davidson Jr., PA is a Physician Assistant in San Rafael, California. Qualified in 2022, 4 years ago. Practices with Clinic Services of California Medical Group Inc, a 66-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
4
Licensed in
CA
In the registry since
2021
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

50 Acacia Ave
San Rafael, CA 94901-2230
Phone: (951) 816-8970
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 62399 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1174294938
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 22, 2021
Last updated in NPPESMarch 7, 2023
Certification dateMarch 7, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Clinic Services Of California Medical Group Inc — 66 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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