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

Mark B Davenport, MD

Individual provider Family Medicine Physician · NPI 1679569636

Mark B Davenport, MD is a Family Practice in Fullerton, California. Qualified in 1982, 44 years ago. Practices with Providence Medical Foundation, a 1,465-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
44
Licensed in
CA
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1835 Sunny Crest Dr
Fullerton, CA 92835-3616
Phone: (714) 446-5101
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2151 N Harbor Blvd, Fullerton, CA 92835-3801 — (714) 446-5101

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence A40119 (CA)

Record details

NPI number1679569636
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 26, 2005
Last updated in NPPESOctober 19, 2020
Certification dateOctober 19, 2020
Mailing address1835 Sunny Crest Dr, Fullerton, CA 92835-3616

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 1982 (44 years in practice)
Group practice Providence Medical Foundation — 1465 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

Other providers in Fullerton