Provider Demographics
NPI:1831129469
Name:CHURCHILL, EMILY S (MD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:S
Last Name:CHURCHILL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:501 WASHINGTON ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2231
Mailing Address - Country:US
Mailing Address - Phone:619-278-3300
Mailing Address - Fax:619-278-3310
Practice Address - Street 1:501 WASHINGTON ST
Practice Address - Street 2:SUITE 600
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2231
Practice Address - Country:US
Practice Address - Phone:619-278-3300
Practice Address - Fax:619-278-3310
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAA78464207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI10334Medicare UPIN