Healthcare Provider Details

I. General information

NPI: 1295589851
Provider Name (Legal Business Name): EMILY POON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2024
Last Update Date: 04/11/2024
Certification Date: 04/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

923 N MILPAS ST
SANTA BARBARA CA
93103-2331
US

IV. Provider business mailing address

11166 MCDONALD ST
CULVER CITY CA
90230-5382
US

V. Phone/Fax

Practice location:
  • Phone: 805-884-1998
  • Fax:
Mailing address:
  • Phone: 949-892-7208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: