Healthcare Provider Details

I. General information

NPI: 1215639422
Provider Name (Legal Business Name): KATHERINE ANNETTE ADLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18460 ROSCOE BLVD FL 3
NORTHRIDGE CA
91325-4107
US

IV. Provider business mailing address

3400 DATA DR ATTENTION TO: CREDENTIALING/PAYER ENROLLMENT DEPARTMENT
RANCHO CORDOVA CA
95670
US

V. Phone/Fax

Practice location:
  • Phone: 818-885-5480
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA201860
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: