Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | G60386 | CA |
NPI | 1013074632 |
---|---|
Provider Name | Kent Marc-Josef Adler |
First Address | San Mateo, CA 94402-3913 |
Second Address | San Mateo, CA 94402-3913 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F01287 | (02) | CA |