Healthcare Provider Details

I. General information

NPI: 1124554225
Provider Name (Legal Business Name): EMNET ALEMU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMENET ALEMU M.D.

II. Dates (important events)

Enumeration Date: 05/10/2017
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15333 CULVER DR STE 130
IRVINE CA
92604-7134
US

IV. Provider business mailing address

9850 GENESEE AVE STE 320
LA JOLLA CA
92037-1208
US

V. Phone/Fax

Practice location:
  • Phone: 858-554-1212
  • Fax: 858-795-1195
Mailing address:
  • Phone: 858-554-1212
  • Fax: 858-795-1195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101218226
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA199206
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: