Provider Demographics
NPI:1821146879
Name:EMMONS, MARIE D (MD)
Entity type:Individual
Prefix:DR
First Name:MARIE
Middle Name:D
Last Name:EMMONS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARIE
Other - Middle Name:D
Other - Last Name:ADRIEN-EMMONS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:860 HAMPSHIRE RD STE P
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-6020
Mailing Address - Country:US
Mailing Address - Phone:818-406-5478
Mailing Address - Fax:
Practice Address - Street 1:860 HAMPSHIRE RD STE P
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-6020
Practice Address - Country:US
Practice Address - Phone:818-406-5478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG54908207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology