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General NPI Number Information
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NPI Number | 1508144106
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Entity Type | Organization
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Legal Business Name | ADAM P. NELSON, MD
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Dates
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Enumeration Date | 07/30/2011
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Last Update Date | 08/21/2013
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Provider Practice Location Address
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Address Line | 45 CAMINO ALTO SUITE 200
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City | MILL VALLEY
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State | CA
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Zip | 94941-2929
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Country | US
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Telephone | 415-460-6710
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Fax | 415-460-6710
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Provider Business Mailing Address
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Address Line | 145 CORTE MADERA TOWN CTR PMB 594
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City | CORTE MADERA
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State | CA
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Zip | 94925-1209
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Country | US
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Telephone | 415-460-6710
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Fax | 415-460-6710
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Authorized Official
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Title or Position | PROPRIETOR
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Name | ADAM P NELSON
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Credential | M.D.
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Telephone | 415-460-6710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | G68858
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License Number State | CA
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