Basic Information
| Provider Information | |||||||||
| NPI: | 1578593307 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JOSEPH DONNELLY, M.D., A PROFESSIONAL CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1319 | ||||||||
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| City: | SALIDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953681319 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2095436279 | ||||||||
| FaxNumber: | 2095436280 | ||||||||
| Practice Location | |||||||||
| Address1: | 1133 E STANLEY BLVD | ||||||||
| Address2: | SUITE 111 | ||||||||
| City: | LIVERMORE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945504200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9253715377 | ||||||||
| FaxNumber: | 9253710948 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/04/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | DONNELLY | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | MD/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9253715377 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | A78117 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.