Provider Demographics
NPI:1437207602
Name:GADLER, JUDY (LAC)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:
Last Name:GADLER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3456 CAMINO DEL RIO N
Mailing Address - Street 2:SUITE #100
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1713
Mailing Address - Country:US
Mailing Address - Phone:619-281-7696
Mailing Address - Fax:619-521-0443
Practice Address - Street 1:3456 CAMINO DEL RIO N
Practice Address - Street 2:SUITE #100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1713
Practice Address - Country:US
Practice Address - Phone:619-281-7696
Practice Address - Fax:619-521-0443
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 6491171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist