Provider Demographics
NPI:1992686075
Name:NIELSEN, DONALD MARTIN (MD)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:MARTIN
Last Name:NIELSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 OXFORD CT
Mailing Address - Street 2:
Mailing Address - City:ALAMO
Mailing Address - State:CA
Mailing Address - Zip Code:94507-1753
Mailing Address - Country:US
Mailing Address - Phone:925-933-4710
Mailing Address - Fax:
Practice Address - Street 1:195 OXFORD CT
Practice Address - Street 2:
Practice Address - City:ALAMO
Practice Address - State:CA
Practice Address - Zip Code:94507-1753
Practice Address - Country:US
Practice Address - Phone:925-933-4710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG36555207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine