Provider Demographics
NPI:1932212123
Name:PUSKAS, ALBERT NMN (MD)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:NMN
Last Name:PUSKAS
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 1:1 LA VISTA VERDE DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-6345
Mailing Address - Country:US
Mailing Address - Phone:310-849-8535
Mailing Address - Fax:
Practice Address - Street 1:1 LA VISTA VERDE DR
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-6345
Practice Address - Country:US
Practice Address - Phone:310-849-8535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC28109173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine