Provider Demographics
NPI:1922016286
Name:EMGE, LAURA (MD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:EMGE
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 1:3160 FOLSOM BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5202
Mailing Address - Country:US
Mailing Address - Phone:916-733-3305
Mailing Address - Fax:916-733-3337
Practice Address - Street 1:3160 FOLSOM BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5202
Practice Address - Country:US
Practice Address - Phone:916-733-3305
Practice Address - Fax:916-733-3337
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA87536208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1931593OtherGREAT WEST
CA237353OtherINTERPLAN
CA00A875360OtherBLUE SHIELD
CA7164546OtherAETNA
CA106610OtherHEALTH NET
CA00A875360Medicaid
CA2391463OtherUNITED HEALTHCARE
CA4478888OtherCIGNA
CA90142077OtherPACIFICARE
CAMCMG357400OtherWESTERN HEALTH ADVANTAGE
CA000810614198OtherPHCS
CA2146454OtherFIRST HEALTH
CAA87536OtherBLUE CROSS
CAMCMG357400OtherWESTERN HEALTH ADVANTAGE