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NPI Code Detail

MEDICARE: DR. EMMA LONGO MD, MPH

MEDICARE: DR. EMMA LONGO MD, MPH
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
1208600000XSurgery PhysicianPTL20473CA

General Provider Information

NPI Number : 1740045293
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EMMA LONGO MD, MPH
Provider Business Mailing Address
First Line : 1520 SAN PABLO ST STE 4300
Second Line :
City : LOS ANGELES
State : CA
Zip : 90033-5330
Country : US
Telephone Number : 323-442-1900
Fax Number :
Provider Business Practice Location Address
First Line : 2051 MARENGO ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90033-1352
Country : US
Telephone Number : 323-409-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2024
Last Update Date : 05/26/2026

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