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General NPI Number Information
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NPI Number | 1164517652
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Entity Type | Individual
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Provider Name | JERROLD E NADLER MD
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2182 HIGHWAY 4
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City | ARNOLD
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State | CA
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Zip | 95223
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Country | US
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Telephone | 209-795-4193
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1372
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City | MURPHYS
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State | CA
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Zip | 95247-1372
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Country | US
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Telephone | 209-728-2554
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G22714
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | G22714
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License Number State | CA
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