Healthcare Provider Details

I. General information

NPI: 1144057639
Provider Name (Legal Business Name): EMOPTI PN PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2024
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2108 N ST STE N
SACRAMENTO CA
95816-5712
US

IV. Provider business mailing address

811 W 7TH ST
LOS ANGELES CA
90017-3408
US

V. Phone/Fax

Practice location:
  • Phone: 217-737-3508
  • Fax:
Mailing address:
  • Phone: 253-242-2705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KRISTIN KLEINHANS
Title or Position: DIR OF NETWORK OPERATIONS
Credential:
Phone: 262-208-4711