Provider Demographics
NPI:1972574085
Name:BRESLOW, ADAM D (MD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:D
Last Name:BRESLOW
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3860 CALLE FORTUNADA
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123
Mailing Address - Country:US
Mailing Address - Phone:858-636-4300
Mailing Address - Fax:858-636-4319
Practice Address - Street 1:765 MEDICAL CENTER CT
Practice Address - Street 2:#210
Practice Address - City:CULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911
Practice Address - Country:US
Practice Address - Phone:619-482-3090
Practice Address - Fax:619-482-7350
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2011-01-28
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Provider Licenses
StateLicense IDTaxonomies
CAG60853208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG60853OtherMD LICENSE
E50586Medicare UPIN