Active NPI
Keith Allen Emmons, M.D.
- Public Health & General Preventive Medicine Physician
- Los Angeles, CA
National Provider Identifier
1144592783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health & General Preventive Medicine Physician
- License
- G54888
- Practice address
- 865 Comstock Ave
Unit 3B
Los Angeles, CA 90024-2572 - Phone
- (818) 512-5575
- Fax
- (310) 275-0832
- NPI assigned
- Jan 28, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | G54888 | CA | Primary |
Addresses
Primary practice location
865 Comstock Ave
Unit 3B
Los Angeles, CA 90024-2572
Mailing address
865 Comstock Ave
Unit 3B
Los Angeles, CA 90024-2572
Phone (818) 512-5575
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G54888 | CA | MD | Public Health & General Preventive Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327708800000",
"number": "1144592783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "865 COMSTOCK AVE",
"address_2": "UNIT 3B",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900242572",
"telephone_number": "818-512-5575",
"fax_number": "310-275-0832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "865 COMSTOCK AVE",
"address_2": "UNIT 3B",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900242572",
"telephone_number": "818-512-5575",
"fax_number": "310-275-0832"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EMMONS",
"first_name": "KEITH",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-01-28",
"last_updated": "2012-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "CA",
"license": "G54888",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.