Provider Demographics
NPI:1295899482
Name:ARTHUR N DONALDSON M D INC
Entity type:Organization
Organization Name:ARTHUR N DONALDSON M D INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:ARDRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-532-0340
Mailing Address - Street 1:940 SYLVA LN
Mailing Address - Street 2:SUITE G
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-5969
Mailing Address - Country:US
Mailing Address - Phone:209-736-6555
Mailing Address - Fax:209-532-1687
Practice Address - Street 1:595 STANISLAUS AVE.
Practice Address - Street 2:SUITE A
Practice Address - City:ANGELS CAMP
Practice Address - State:CA
Practice Address - Zip Code:95222-0387
Practice Address - Country:US
Practice Address - Phone:209-736-5555
Practice Address - Fax:209-532-1687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ27242ZOtherBLUE SHIELD GROUP PROVIDR
CAC08447018OtherNSC ENVOY SUBMITTER
CAGR0085461Medicaid
CA110900OtherEYEMED
CAZZZ27242ZOtherBLUE SHIELD GROUP PROVIDR
CAZZZ27242ZMedicare ID - Type UnspecifiedMEDICARE NHIC
CA1299310002Medicare ID - Type UnspecifiedMEDICARE REGION D