Provider Demographics
NPI:1437100963
Name:ADLER, ALLAN (MD)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:
Last Name:ADLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ALAN
Other - Middle Name:
Other - Last Name:ADLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:STINSON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:94970-0248
Mailing Address - Country:US
Mailing Address - Phone:415-868-9593
Mailing Address - Fax:
Practice Address - Street 1:3200 PROVIDENCE DR
Practice Address - Street 2:SUITE D 338
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4615
Practice Address - Country:US
Practice Address - Phone:907-212-3435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ375022080P0214X
CAG595012080P0214X
NMMD2014-06662080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
003000261POtherHUMANA
WI34163200Medicaid
0002E73601Medicare ID - Type Unspecified
WI34163200Medicaid