Provider Demographics
NPI:1942245907
Name:JANES, DONALD NELSON JR (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:NELSON
Last Name:JANES
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2426 BUHNE ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-3207
Mailing Address - Country:US
Mailing Address - Phone:707-443-4666
Mailing Address - Fax:907-313-1400
Practice Address - Street 1:2426 BUHNE ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-3207
Practice Address - Country:US
Practice Address - Phone:707-443-4666
Practice Address - Fax:907-313-1400
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2024-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA84937207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A849370Medicaid
CA00A849371Medicare PIN
CA00A849370Medicaid