DR. SUSAN LEE IVEY MD NPI 1003004169

Family Medicine in Berkeley, CA

About SUSAN IVEY

Susan Ivey is a provider in Berkeley, CA. The NPI number assigned to this provider is 1003004169. The practitioner's primary taxonomy code is Family Medicine (207Q00000X). The provider is registered as an individual and their NPI record was last updated 10 years ago.

NPI1003004169 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameDR. SUSAN LEE IVEY MD
Provider Location Address2140 SHATTUCK AVE 10TH FLOOR, HEALTH RESEARCH FOR ACTION, UC-BERKELEY SPH BERKELEY, CA 94704 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address131 EMERALD DR DANVILLE, CA 94526 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
GenderFemale
NPI Entity TypeIndividual Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?No
Is Organization Subpart?N/A Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date10-12-2007 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date10-12-2007 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

DR. SUSAN LEE IVEY MD
2140 SHATTUCK AVE
10TH FLOOR, HEALTH RESEARCH FOR ACTION, UC-BERKELEY SPH
BERKELEY, CA
ZIP 94704
Phone: (510) 643-1883
Fax: (510) 643-7976
Get Directions

Mailing Address

DR. SUSAN LEE IVEY MD
131 EMERALD DR
DANVILLE, CA
ZIP 94526
Phone: (925) 362-8227
Fax: (925) 362-8228

Primary Taxonomy

Taxonomy Code207Q00000X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
License No.C43335
License StateCA
Taxonomy DescriptionFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
D87707MEDICARE UPIN (02)CA

Map Location


DR. SUSAN LEE IVEY MD address is 2140 SHATTUCK AVE 10TH FLOOR, HEALTH RESEARCH FOR ACTION, UC-BERKELEY SPH BERKELEY, CA 94704

Other Providers at the same location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1235113077MS. KAREN M ROSE MFT
Individual
Marriage & Family Therapist2140 SHATTUCK AVE SUITE 503
BERKELEY, CA 94704
(510) 486-1188
1265816235BERKELEY HEALTH ACUPUNCTURE
Organization
Acupuncturist2140 SHATTUCK AVE STE 510
BERKELEY, CA 94704
(415) 988-1619
1346335627DR. GEORGE MARTIN OLDENBOURG JR. D.D.S.
Individual
Dentist (General Practice)2140 SHATTUCK AVE STE 701
BERKELEY, CA 94704
(510) 843-1192
1609114669DR. SIMARJIT SINGH D.D.S.
Individual
Dentist2140 SHATTUCK AVE
BERKELEY, CA 94704
(510) 843-1192
1881880557MR. JAY ELI WILLIAMS ASW 27280
Individual
Social Worker (Clinical)2140 SHATTUCK AVE SUITE 711
BERKELEY, CA 94704
(510) 841-1100