Provider Demographics
NPI:1376632844
Name:EMERY, TALIA KATE (MD)
Entity Type:Individual
Prefix:DR
First Name:TALIA
Middle Name:KATE
Last Name:EMERY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4874 VIA ANDREA
Mailing Address - Street 2:
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320-6809
Mailing Address - Country:US
Mailing Address - Phone:805-499-5572
Mailing Address - Fax:
Practice Address - Street 1:1510 W VERDUGO AVE
Practice Address - Street 2:SUITE E
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2472
Practice Address - Country:US
Practice Address - Phone:818-954-0510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA78999174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist