Provider Demographics
NPI:1588707566
Name:VEATER, EMELY IVONNE (PA)
Entity type:Individual
Prefix:MISS
First Name:EMELY
Middle Name:IVONNE
Last Name:VEATER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:587 N NEW HAMPSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-2136
Mailing Address - Country:US
Mailing Address - Phone:323-807-1046
Mailing Address - Fax:818-361-6427
Practice Address - Street 1:587 N NEW HAMPSHIRE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-2136
Practice Address - Country:US
Practice Address - Phone:323-807-1046
Practice Address - Fax:818-361-6427
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA 12899363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant