Healthcare Provider Details

I. General information

NPI: 1982187555
Provider Name (Legal Business Name): EMERALD KHOO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2018
Last Update Date: 09/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11766 VALLEY BLVD
EL MONTE CA
91732-3044
US

IV. Provider business mailing address

35 W LEMON AVE
ARCADIA CA
91007-8028
US

V. Phone/Fax

Practice location:
  • Phone: 626-448-5000
  • Fax:
Mailing address:
  • Phone: 626-388-6227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number102700
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: