Healthcare Provider Details

I. General information

NPI: 1558497263
Provider Name (Legal Business Name): ARTHUR N DONALDSON M D INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 03/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 SYLVA LN SUITE G
SONORA CA
95370-5969
US

IV. Provider business mailing address

940 SYLVA LN SUITE G
SONORA CA
95370-5969
US

V. Phone/Fax

Practice location:
  • Phone: 209-532-0340
  • Fax: 209-532-1687
Mailing address:
  • Phone: 209-532-0340
  • Fax: 209-532-1687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number030000368
License Number StateCA

VIII. Authorized Official

Name: DR. GERARD EMILE ARDRON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 209-532-0340