MEDICARE: MRS. EMILY LAMBERT DALTON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	G76290	CA

General Provider Information

NPI Number	:	1235133737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EMILY LAMBERT DALTON MD

Provider Business Mailing Address
First Line	:	670 9TH ST STE 203
Second Line	:
City	:	ARCATA
State	:	CA
Zip	:	95521-6249
Country	:	US
Telephone Number	:	707-826-8633
Fax Number	:	707-826-8638

Provider Business Practice Location Address
First Line	:	2800 HARRIS ST
Second Line	:
City	:	EUREKA
State	:	CA
Zip	:	95503-4809
Country	:	US
Telephone Number	:	707-445-8416
Fax Number	:	707-445-4182

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	10/29/2020

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