Healthcare Provider Details

I. General information

NPI: 1871519694
Provider Name (Legal Business Name): EMILY L WHITCOMB M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 11/29/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W ARBOR DR
SAN DIEGO CA
92103-9000
US

IV. Provider business mailing address

5388 WILSHIRE DR
SAN DIEGO CA
92116-1958
US

V. Phone/Fax

Practice location:
  • Phone: 888-309-8273
  • Fax:
Mailing address:
  • Phone: 619-640-2636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA87926
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberA87926
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: