Provider Demographics
NPI:1366702946
Name:JIANG, EMILY KING (MD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:KING
Last Name:JIANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:EMILY
Other - Middle Name:TI-EN
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4000 CALLE TECATE STE 211
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-5287
Mailing Address - Country:US
Mailing Address - Phone:805-233-3314
Mailing Address - Fax:
Practice Address - Street 1:4000 CALLE TECATE STE 211
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-5287
Practice Address - Country:US
Practice Address - Phone:805-233-3314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-17
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036136469207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine