Provider Demographics
NPI:1326364266
Name:NUNEZ-ADLER, JORGE ALBERTO (LAC)
Entity Type:Individual
Prefix:MR
First Name:JORGE
Middle Name:ALBERTO
Last Name:NUNEZ-ADLER
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3523 MEADOW ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-3815
Mailing Address - Country:US
Mailing Address - Phone:510-682-8030
Mailing Address - Fax:
Practice Address - Street 1:3523 MEADOW ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94601-3815
Practice Address - Country:US
Practice Address - Phone:510-682-8030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-16
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7209171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist