Healthcare Provider Details

I. General information

NPI: 1609939818
Provider Name (Legal Business Name): KARL DANIEL ADLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: (NONE) (NONE)

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 FRANCISCO ST
BERKELEY CA
94709-2125
US

IV. Provider business mailing address

2045 FRANCISCO ST
BERKELEY CA
94709-2125
US

V. Phone/Fax

Practice location:
  • Phone: 510-524-4499
  • Fax:
Mailing address:
  • Phone: 510-524-4499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG66450
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: