Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSY19167 | CA |
Y | 103T00000X | Psychologist | PSY19167 | CA |
NPI | 1003062225 |
---|---|
Provider Name | Dr. Mitchel Gregg Adler |
First Address | Davis, CA 95616-4111 |
Second Address | Davis, CA 95616-4111 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2008 |
Last Update Date | 08/08/2008 |