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DR. SUSAN LEE IVEY MD NPI 1003004169


NPI Profile

NPI: 1003004169
Provider Name: DR. SUSAN LEE IVEY, MD
Classification:Family Medicine - 207Q00000X
Entity Type: Individual
Address:
2140 SHATTUCK AVE
10TH FLOOR, HEALTH RESEARCH FOR ACTION, UC-BERKELEY SPH
BERKELEY, CA
ZIP 94704
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Phone: (510) 643-1883

DR. Susan Lee Ivey, MD is a family medicine in Berkeley, CA. The provider is family 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. DR. Susan Lee Ivey, MD NPI is 1003004169. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2140 SHATTUCK AVE
10TH FLOOR, HEALTH RESEARCH FOR ACTION, UC-BERKELEY SPH
BERKELEY, CA
ZIP 94704-210
Phone: (510) 643-1883
Fax: (510) 643-7976

The enumeration date for this NPI number is 10/12/2007 and was last updated on 10/12/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineC43335CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1D87707MEDICARE UPINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 6/14/2021

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