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General NPI Number Information
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NPI Number | 1417480252
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Entity Type | Individual
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Provider Name | EMILY KATHRYN FUNK
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Gender | Female
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Dates
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Enumeration Date | 04/08/2017
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Last Update Date | 08/15/2023
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Provider Practice Location Address
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Address Line | 200 W ARBOR DR MC 8895
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City | SAN DIEGO
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State | CA
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Zip | 92103-9000
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Country | US
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Telephone | 619-543-1967
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Fax | 619-543-5521
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Provider Business Mailing Address
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Address Line | 925 CHESTNUT ST FL 6
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4204
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Country | US
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Telephone | 215-955-6056
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | MD480835
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License Number State | PA
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