Individual
LOUIS ALBERT IVEY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 MERCED ST, SAN LEANDRO, CA 94577-4201
(510) 454-1000
Mailing address
1320 EL CAPITAN DR, STE 120, DANVILLE, CA 94526-6260
(925) 334-5800
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G76248
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G762480
—
CA
Enumeration date
11/01/2006
Last updated
09/09/2022
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