Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | G17468 | CA |
NPI | 1043391246 |
---|---|
Provider Name | Steven Emmet |
First Address | Solana Beach, CA 92075-2031 |
Second Address | Solana Beach, CA 92075-2031 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A90497 | (02) | CA |