Provider Demographics
NPI:1699394809
Name:EMONT, JORDAN PAUL (MD MPH SCM)
Entity Type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:PAUL
Last Name:EMONT
Suffix:
Gender:M
Credentials:MD MPH SCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1885 BAY RD
Mailing Address - Street 2:
Mailing Address - City:EAST PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-1312
Mailing Address - Country:US
Mailing Address - Phone:650-330-7400
Mailing Address - Fax:
Practice Address - Street 1:622 W 168TH ST PH 16
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3720
Practice Address - Country:US
Practice Address - Phone:212-305-2463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA192120207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology