Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0300X | Geriatric Medicine | 25MA06712300 | NJ |
Y | 207RG0300X | Geriatric Medicine | C53572 | CA |
NPI | 1093746299 |
---|---|
Provider Name | Dr. Emma Concepcion Javier |
First Address | Palm Desert, CA 92211-2080 |
Second Address | Palm Desert, CA 92211-2080 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 14/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0002461 | (05) | NJ |
0103605000 | AMERIHEALTH (01) | NJ |
H21745 | (02) | NJ |