Provider Demographics
NPI:1134415185
Name:ADLER, ALBINA (LAC)
Entity type:Individual
Prefix:
First Name:ALBINA
Middle Name:
Last Name:ADLER
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 1:19231 VICTORY BLVD STE 350
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-6350
Mailing Address - Country:US
Mailing Address - Phone:818-602-0822
Mailing Address - Fax:
Practice Address - Street 1:19231 VICTORY BLVD STE 350
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-6350
Practice Address - Country:US
Practice Address - Phone:818-602-0822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13670171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist