Provider Demographics
NPI:1669600755
Name:ADLER, ELDAD (MD)
Entity type:Individual
Prefix:DR
First Name:ELDAD
Middle Name:
Last Name:ADLER
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 1:72057 DINAH SHORE DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-1791
Mailing Address - Country:US
Mailing Address - Phone:760-340-3937
Mailing Address - Fax:
Practice Address - Street 1:72057 DINAH SHORE DR
Practice Address - Street 2:BLDG. D
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-1791
Practice Address - Country:US
Practice Address - Phone:760-340-3937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-26
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA 118178207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA125747Medicare PIN
CACA125746Medicare PIN
CACA125745Medicare PIN