MEDICARE: DR. ADAM R. PACAL M.D.

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	207R00000X	Internal Medicine Physician	A89259	CA

General Provider Information

NPI Number	:	1861432270
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM R. PACAL M.D.

Provider Business Mailing Address
First Line	:	3555 KENYON ST
Second Line	:	STE 200&201
City	:	SAN DIEGO
State	:	CA
Zip	:	92110-5341
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3555 KENYON ST
Second Line	:	STE 200&201
City	:	SAN DIEGO
State	:	CA
Zip	:	92110-5341
Country	:	US
Telephone Number	:	858-499-2712
Fax Number	:

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

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	06/21/2016

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