Provider Demographics
NPI:1710077698
Name:PAPADAKIS, EMMANUEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:EMMANUEL
Middle Name:J
Last Name:PAPADAKIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1744 ALMADEN DR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-2252
Mailing Address - Country:US
Mailing Address - Phone:530-241-0473
Mailing Address - Fax:530-241-5377
Practice Address - Street 1:2175 ROSALINE AVE
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-2549
Practice Address - Country:US
Practice Address - Phone:530-241-1473
Practice Address - Fax:530-232-0157
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2020-11-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA47908207RI0011X
ART2007-022207RI0011X
MO2012018819207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG87800Medicare UPIN
MO144790011Medicare PIN