Provider Demographics
NPI:1992157317
Name:JAMES, EMILY PAULINE (OD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:PAULINE
Last Name:JAMES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1759 HAPPY TRL APT 6
Mailing Address - Street 2:
Mailing Address - City:TOPANGA
Mailing Address - State:CA
Mailing Address - Zip Code:90290-4206
Mailing Address - Country:US
Mailing Address - Phone:928-699-1077
Mailing Address - Fax:
Practice Address - Street 1:10921 WILSHIRE BLVD
Practice Address - Street 2:#900
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-3906
Practice Address - Country:US
Practice Address - Phone:310-208-3937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-09
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33479152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPENDINGMedicaid