Healthcare Provider Details

I. General information

NPI: 1770445124
Provider Name (Legal Business Name): ALBERT ADAME
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10089 WILLOW CREEK RD STE 200
SAN DIEGO CA
92131-1699
US

IV. Provider business mailing address

10089 WILLOW CREEK RD STE 200
SAN DIEGO CA
92131-1699
US

V. Phone/Fax

Practice location:
  • Phone: 619-638-4470
  • Fax:
Mailing address:
  • Phone: 619-638-4470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP0904X
TaxonomyFederal Public Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: