Provider Demographics
NPI:1912373226
Name:PINHO, EMILY
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:PINHO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 MARSHALLFIELD LN
Mailing Address - Street 2:#2
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-4135
Mailing Address - Country:US
Mailing Address - Phone:617-818-6273
Mailing Address - Fax:
Practice Address - Street 1:1819 MARSHALLFIELD LN
Practice Address - Street 2:#2
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-4135
Practice Address - Country:US
Practice Address - Phone:617-818-6273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-20
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA748902367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered