Healthcare Provider Details

I. General information

NPI: 1942245907
Provider Name (Legal Business Name): DONALD NELSON JANES JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 09/14/2024
Certification Date: 09/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2426 BUHNE ST
EUREKA CA
95501-3207
US

IV. Provider business mailing address

2426 BUHNE ST
EUREKA CA
95501-3207
US

V. Phone/Fax

Practice location:
  • Phone: 707-443-4666
  • Fax: 907-313-1400
Mailing address:
  • Phone: 707-443-4666
  • Fax: 907-313-1400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA84937
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA84937
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: