Susan Lee Ivey MD

NPI 1003004169 - Family Medicine - 207Q00000X

NPI Details
NPI 1003004169
Gender Female
Enumeration Date 10/12/2007
Last Updated 10/12/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
2140 SHATTUCK AVE
10TH FLOOR, HEALTH RESEARCH FOR ACTION, UC-BERKELEY SPH
BERKELEY CA, 94704-1210, US
Phone (510) 643-1883
Fax (510) 643-7976
Business Location
131 EMERALD DR
DANVILLE CA, 94526-2426, US
Phone (925) 362-8227
Fax (925) 362-8228
Toxanomy
Taxonomy Code 207Q00000X
License State California
License Number C43335
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According to our database, Dr. Susan Lee Ivey MD NPI is 1003004169, taxonomy code is 207Q00000X and license number is C43335, license state is located at California. Susan Lee Ivey MD physically located at 2140 Shattuck Ave, Berkeley CA, 94704-1210. NPI Number Susan Lee Ivey MD has the Individual type.

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1003004169 NPI number is provided on an as is basis without warranty of any kind. 1003004169 is maintained by the National Plan & Provider Enumeration System. The contents of Susan Lee Ivey MD are for informational purposes only.