Provider Demographics
NPI:1174651574
Name:PIONER, ADALBERTO J (CARE COORDINATOR)
Entity Type:Individual
Prefix:MR
First Name:ADALBERTO
Middle Name:J
Last Name:PIONER
Suffix:
Gender:M
Credentials:CARE COORDINATOR
Other - Prefix:MR
Other - First Name:AL
Other - Middle Name:J
Other - Last Name:PIONER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CARE COORDINATOR
Mailing Address - Street 1:9410 BIETINGER DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-4515
Mailing Address - Country:US
Mailing Address - Phone:907-274-7111
Mailing Address - Fax:907-646-1237
Practice Address - Street 1:9410 BIETINGER DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515
Practice Address - Country:US
Practice Address - Phone:907-274-7111
Practice Address - Fax:907-646-1237
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKCMG274251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCM3751Medicaid
AKCMG274Medicaid