Provider Demographics
NPI:1942438254
Name:CUELLAR, ADRIAN MANUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:MANUEL
Last Name:CUELLAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3985 CUMMINGS RD STE 4
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92136-5218
Mailing Address - Country:US
Mailing Address - Phone:915-227-9454
Mailing Address - Fax:
Practice Address - Street 1:3985 CUMMINGS RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92136-1098
Practice Address - Country:US
Practice Address - Phone:619-556-3590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE25882208D00000X
CAA1164912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice