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General NPI Number Information
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NPI Number | 1346265766
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Entity Type | Individual
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Provider Name | MARK EDWARD ADLARD M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 10/13/2010
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Provider Practice Location Address
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Address Line | 22342 AVENIDA EMPRESA SUITE 195
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City | RANCHO SANTA MARGARITA
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State | CA
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Zip | 92688-2140
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Country | US
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Telephone | 949-858-7001
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Fax | 949-858-3826
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Provider Business Mailing Address
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Address Line | 22342 AVENIDA EMPRESA SUITE 195
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City | RANCHO SANTA MARGARITA
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State | CA
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Zip | 92688-2140
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Country | US
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Telephone | 949-858-7001
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Fax | 949-858-3826
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G64159
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License Number State | CA
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