Provider Demographics
NPI:1174877062
Name:ADAME, ARTURO JESUS (IDC)
Entity type:Individual
Prefix:MR
First Name:ARTURO
Middle Name:JESUS
Last Name:ADAME
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8807 FLOWER ST
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-5109
Mailing Address - Country:US
Mailing Address - Phone:562-338-7209
Mailing Address - Fax:
Practice Address - Street 1:8807 FLOWER ST
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-5109
Practice Address - Country:US
Practice Address - Phone:562-338-7209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-31
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman