Provider Demographics
NPI:1831835115
Name:KLUG, EMMA ASHLEY (MD)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:ASHLEY
Last Name:KLUG
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 1:2500 ALHAMBRA AVENUE
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553
Mailing Address - Country:US
Mailing Address - Phone:925-370-5117
Mailing Address - Fax:925-370-5117
Practice Address - Street 1:2500 ALHAMBRA AVENUE
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553
Practice Address - Country:US
Practice Address - Phone:925-370-5117
Practice Address - Fax:925-370-5117
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-09
Last Update Date:2024-06-10
Deactivation Date:2024-05-30
Deactivation Code:
Reactivation Date:2024-06-10
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program