Provider Demographics
NPI:1609207802
Name:DRAKE, ADRIENNE ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:ADRIENNE
Middle Name:ANN
Last Name:DRAKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22486 ALCUDIA
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-1157
Mailing Address - Country:US
Mailing Address - Phone:949-951-0775
Mailing Address - Fax:
Practice Address - Street 1:22486 ALCUDIA
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692-1157
Practice Address - Country:US
Practice Address - Phone:949-951-0775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGFE44173207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine