Provider Demographics
NPI:1326043894
Name:ADLER, JUDY R (MD)
Entity Type:Individual
Prefix:DR
First Name:JUDY
Middle Name:R
Last Name:ADLER
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Gender:F
Credentials:MD
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Mailing Address - Street 1:7920 FROST ST
Mailing Address - Street 2:STE 300
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2736
Mailing Address - Country:US
Mailing Address - Phone:858-499-1900
Mailing Address - Fax:858-268-1911
Practice Address - Street 1:4060 4TH AVE
Practice Address - Street 2:STE 220
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2120
Practice Address - Country:US
Practice Address - Phone:619-299-2350
Practice Address - Fax:619-297-8379
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2008-02-19
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Provider Licenses
StateLicense IDTaxonomies
CAG56817207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G568170Medicaid
CA00G568170Medicaid
CAWG56817AMedicare PIN