Provider Demographics
NPI:1164605093
Name:HUN, EMILY DAVI (PAC)
Entity Type:Individual
Prefix:MISS
First Name:EMILY
Middle Name:DAVI
Last Name:HUN
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:16465 SIERRA LAKES PKWY STE 275
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-1263
Mailing Address - Country:US
Mailing Address - Phone:909-823-8000
Mailing Address - Fax:909-823-8088
Practice Address - Street 1:16465 SIERRA LAKES PKWY STE 275
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336
Practice Address - Country:US
Practice Address - Phone:909-823-8000
Practice Address - Fax:909-823-8088
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19433363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical