Provider Demographics
NPI:1811028038
Name:EMAMI, MARGO AURA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGO
Middle Name:AURA
Last Name:EMAMI
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 1:9850 GENESEE AVE STE 840
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1219
Mailing Address - Country:US
Mailing Address - Phone:858-461-8543
Mailing Address - Fax:
Practice Address - Street 1:9850 GENESEE AVE STE 840
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1219
Practice Address - Country:US
Practice Address - Phone:858-461-8543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG78681261QM2500X
261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG78681Medicare ID - Type UnspecifiedSTATE LICENSE