Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 17676 | CA |
NPI | 1720119084 |
---|---|
Provider Name | Dr. Stephanie T Emi |
First Address | La Crescenta, CA 91214-3909 |
Second Address | La Crescenta, CA 91214-3909 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T18592 | (02) | CA |