MEDICARE: DR. PAUL M ADLER D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	149065	NY

General Provider Information

NPI Number	:	1306909544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL M ADLER D.O.

Provider Business Mailing Address
First Line	:	PO BOX 49353
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-0353
Country	:	US
Telephone Number	:	917-974-8073
Fax Number	:

Provider Business Practice Location Address
First Line	:	611 ESTRELLITA WAY
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-2118
Country	:	US
Telephone Number	:	917-974-8073
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	03/16/2021

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