Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | A117971 | CA |
Y | 207Q00000X | Family Doctor | MD-19470 | HI |
N | 207QS0010X | Family Doctor - Sports Medicine | 53027 | AZ |
NPI | 1184904104 |
---|---|
Provider Name | Emily N. Sumner |
First Address | Kapolei, HI 96707 |
Second Address | Kapolei, HI 96707 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2011 |
Last Update Date | 25/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A1179710 | (05) | CA |