Provider Demographics
NPI:1568705671
Name:SANDER, EMILY ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:ANNE
Last Name:SANDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:EMILY
Other - Middle Name:ANNE
Other - Last Name:EASTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:202 LAWRENCE LN
Mailing Address - Street 2:
Mailing Address - City:YREKA
Mailing Address - State:CA
Mailing Address - Zip Code:96097-3341
Mailing Address - Country:US
Mailing Address - Phone:530-572-1566
Mailing Address - Fax:888-600-6597
Practice Address - Street 1:202 LAWRENCE LN
Practice Address - Street 2:
Practice Address - City:YREKA
Practice Address - State:CA
Practice Address - Zip Code:96097-3341
Practice Address - Country:US
Practice Address - Phone:530-572-1566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD209748202D00000X
CAA138803207P00000X, 202D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1568705671Medicaid