Healthcare Provider Details

I. General information

NPI: 1922016286
Provider Name (Legal Business Name): LAURA EMGE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 12/14/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3160 FOLSOM BLVD
SACRAMENTO CA
95816-5202
US

IV. Provider business mailing address

3160 FOLSOM BLVD
SACRAMENTO CA
95816-5202
US

V. Phone/Fax

Practice location:
  • Phone: 916-733-3305
  • Fax: 916-733-3337
Mailing address:
  • Phone: 916-733-3305
  • Fax: 916-733-3337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA87536
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: