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Individual

DONALD J IVERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2828 ONEIL LANE, EUREKA, CA 95503-4870
(707) 443-9385
(707) 443-0258
Mailing address
2828 ONEIL LANE, EUREKA, CA 95503-4870
(707) 443-9385
(707) 443-0258

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
G60800
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G608000
CA
01
0165084
DEPF OF LABOR & INDUSTRIE
WA
01
130004938
RAILROAD MEDICARE
Enumeration date
05/03/2006
Last updated
11/03/2021
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